Evaluation of the psychometric properties of the Social Phobia Inventory in university students

Objective: The aim of the study was to study the psychometric properties of the Social Phobia Inventory (SPIN) in its version for the context of Brazilian adults. Methods: A sample of Brazilian university students from the general population (n = 2314) and a sample of university students identified as cases (n = 88) and noncases (n = 90) of social phobia were assessed, using as a parameter the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The different instruments were applied individually in the presence of a rater. Results: The SPIN showed adequate internal consistency (.63-.90) and concurrent validity with different instruments of auto- and hetero-evaluation of social phobia. Discriminative validity showed 0.84 to 0.86 sensitivity and 0.84 to 0.87 specificity for cutoff notes between 19 and 21. Factorial analysis showed the presence of a variable number of factors as a function of the different samples. Conclusions: The version of the SPIN studied is quite adequate for use in the context of Brazilian university students, favoring the screening of social phobia. However, further studies using more diverse samples are needed. (C) 2010 Elsevier Inc. All rights reserved.

Further Study of the Psychometric Qualities of a Brief Screening Tool for Social Phobia (MINI-SPIN) Applied to Clinical and Nonclinical Samples

PURPOSE. The purpose of this study was to further assess the psychometric qualities of the Mini-Social Phobia Inventory (MS) to screen for social anxiety disorder (SAD). DESIGN AND METHODS. The MS and other self- and clinician-rated scales for anxiety and social anxiety were applied in 2,314 university students and in samples of SAD patients (n = 88) and nonpatients (n = 90). FINDINGS. The MS revealed adequate discriminative validity, internal consistency (alpha = 0.49-0.73), convergent validity with the Social Phobia Inventory, Brief Social Phobia Scale, and Self-Statements During Public Speaking Scale and convergent and divergent validity with the Beck Anxiety Inventory. PRACTICE IMPLICATIONS. The MS has shown to be a fast and efficient screening instrument for SAD in different cultures and contexts.

Social phobia in Brazilian university students: Prevalence, under-recognition and academic impairment in women

Background: Despite the fact that public speaking is a common academic activity and that social phobia has been associated with lower educational achievement and impaired academic performance, little research has examined the prevalence of social phobia in college students. The aim of this study was to evaluate the prevalence of social phobia in a large sample of Brazilian college students and to examine the academic impact of this disorder. Methods: The Social Phobia Inventory (SPIN) and the MINI-SPIN, used as the indicator of social phobia in the screening phase, were applied to 2319 randomly selected students from two Brazilian universities. For the second phase (diagnostic confirmation), four psychiatrists and one clinical psychologist administered the SCID-IV to subjects with MINI-SPIN scores of 6 or higher. Results: The prevalence of social phobia among the university students was 11.6%. Women with social phobia had significantly lower grades than those without the disorder. Fear of public speaking was the most common social fear. Only two of the 237 students with social phobia (0.8%) had previously received a diagnosis of social phobia and were under treatment. Limitations: Social phobia comorbidities were not evaluated in this study. The methods of assessment employed by the universities (written exams) may mask the presence of social phobia. This was not a population-based study, and thus the results are not generalizable to the entire population with social phobia. Conclusion: Preventive strategies are recommended to reduce the under-recognition and the adverse impact of social phobia on academic performance and overall quality of life of university students. (C) 2011 Elsevier B.V. All rights reserved.

Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report

Animal and human studies indicate that cannabidiol (CBD), a major constituent of cannabis, has anxiolytic properties. However, no study to date has investigated the effects of this compound on human pathological anxiety and its underlying brain mechanisms. The aim of the present study was to investigate this in patients with generalized social anxiety disorder (SAD) using functional neuroimaging. Regional cerebral blood flow (rCBF) at rest was measured twice using (99m)Tc-ECD SPECT in 10 treatment-naive patients with SAD. In the first session, subjects were given an oral dose of CBD (400 mg) or placebo, in a double-blind procedure. In the second session, the same procedure was performed using the drug that had not been administered in the previous session. Within-subject between-condition rCBF comparisons were performed using statistical parametric mapping. Relative to placebo, CBD was associated with significantly decreased subjective anxiety (p < 0.001), reduced ECD uptake in the left parahippocampal gyrus, hippocampus, and inferior temporal gyrus (p < 0.001, uncorrected), and increased ECD uptake in the right posterior cingulate gyrus (p < 0.001, uncorrected). These results suggest that CBD reduces anxiety in SAD and that this is related to its effects on activity in limbic and paralimbic brain areas.

Validação da versão brasileira do questionário de ansiedade cardíaca

FUNDAMENTOS: A ansiedade cardíaca (AC) é o medo de sensações cardíacas, caracterizado por sintomas recorrentes de ansiedade em pacientes com ou sem doença cardiovascular. O Questionário de Ansiedade Cardíaca (QAC) é uma ferramenta para avaliar a AC, já adaptado, mas não validado em português. OBJETIVO: Este trabalho apresenta as três fases dos estudos de validação do QAC brasileiro. MÉTODOS: Foram recrutados 98 pacientes com doença arterial coronária, a fim de extrair a estrutura fatorial e avaliar a confiabilidade do QAC (fase 1). O objetivo da fase 2 foi explorar a validade convergente e divergente. Cinquenta e seis pacientes completaram o QAC, juntamente com o Escala de sensações corporais (ESC) e o Versão brasileira do Social Phobia Inventory (SPIN). Para determinar a validade discriminante (fase 3), comparamos os escores do QAC de dois subgrupos formados por pacientes da fase 1 (n = 98), de acordo com os diagnósticos de transtorno do pânico e agorafobia obtidos com o MINI - Mini International Neuropsychiatric Interview (Mini Entrevista Neuropsiquiátrica Internacional). RESULTADOS: A solução de dois fatores foi a mais interpretável (46,4% da variância). As subescalas foram denominadas de "Medo e Hipervigilância" (n = 9; alfa = 0,88) e "Evitação" (n = 5; alfa = 0,82). Foi encontrada correlação significativa do fator 1 com o escore total do ESC (p < 0,01), mas não com o fator 2. Os fatores do SPIN apresentaram correlações significativas com as subescalas do QAC (p < 0,01). Na fase 3, os escores dos pacientes "Cardíacos com pânico" foram significativamente maiores no fator 1 do QAC (t = -3,42; p < 0,01, IC = -1,02 a -0,27), e maiores, mas não significativamente diferentes, no fator 2 (t = -1,98; p = 0,51, IC = -0.87 a 0,00). CONCLUSÕES: Os presentes resultados fornecem uma versão final brasileira validada do QAC adequada aos contextos clínicos e de pesquisa.

Transtorno de ansiedade social e insatisfação com a imagem corporal em estudantes de medicina: prevalência e fatores associados

Pós-graduação em Saúde Coletiva - FMB

Study of the psychometric qualities of the Brief Social Phobia Scale (BSPS) in Brazilian university students

Purpose: To perform a psychometric analysis of the Brazilian version of the Brief Social Phobia Scale (BSPS). Materials and methods: Hundred and seventy-eight university students of both genders aged on average 21.2 years and identified as Social Anxiety Disorder (SAD) cases and non-cases was studied, with the structured clinical interview for DSM-IV being used as a parameter. The different instruments were applied in an individual manner in the presence of a rater and of an observer. Results: The BSPS showed adequate internal consistency (0.48-0.88) and concurrent and divergent validity with the Beck Anxiety Inventory (BAI) (0.21-0.62), Social Phobia Inventory (0.24-0.82) and Self Statements During Public Speaking Scale (SSPS) (0.23-0.31). Discriminative validity revealed a sensitivity of 0.88-0.90 and a specificity of 0.81(0.83 for cut-off notes of 18/19. Factorial analysis demonstrated the presence of six factors that jointly explained 71.79% of data variance. Construct validity indicated some limits of the scale regarding the diagnosis of SAD. Inter-rater reliability was strong (0.86-1.00, p < 0.001). Conclusions: The BSPS is adequate for use with university students, although further studies in different cultures, samples and contexts are still necessary. (C) 2009 Elsevier Masson SAS. All rights reserved.

Using the Social Skills Inventory in the Diagnosis of Social Anxiety Disorder

This study aimed to assess the relationship between clinical and behavioral manifestations of the Social Anxiety Disorder (SAD) and verify the discriminative validity of the Social Skills Inventory (SSI-Del-Prette) in the diagnosis of this disorder. The participants were 1,006 undergraduates, aged between 17 and 35 years old, both genders. Subsequently, 86 participants were randomly selected from the initial sample and grouped as SAD cases and non-SAD cases through systematic clinical evaluation. The results indicated that the more elaborate the repertoire of social skills of an individual is, the lower his/her likelihood of meeting the screening criteria of diagnostic indicators for SAD. Furthermore, the SSI-Del-Prette has demonstrated to significantly distinguish individuals with and without SAD, evidencing, thus, its discriminative validity.

Social anxiety disorder: studies of instrument validation for the Brazilian context

Social anxiety disorder (SAD) is a highly prevalent condition even though its recognition and diagnosis are underestimated by both patients and clinicians. In view of the importance of assessment scales for systematic diagnosis in psychiatry, the objective of this investigation was to present studies of validation for the Brazilian population of three instruments for the assessment of different aspects of SAD. The following psychometric studies were carried out: a) discriminative validity of the Mini Social Phobia Inventory (Mini-SPIN-MS), a reduced instrument for the screening of SAD; b) reliability and discriminative validity of the Brief Social Phobia Scale (BSPS), a hetero-applied instrument for the assessment of different aspects of SAD, and c) discriminative validity of the items and subscales of the Self-Statements during Public Speaking Scale (SSPS), an instrument for the assessment of cognitive aspects related to public speaking. All instruments showed excellent psychometric qualities, especially indicators of discrimination between persons with and without SAD, with diagnostic confirmation by the Structured Clinical Interview for DSM-IV (SCID-IV). It was concluded that this set of instruments, with specificity regarding their objectives, could be of great clinical usefulness, especially for the Brazilian population that, until recently, had no such resources for the measurement and assessment of the different aspects of SAD. New multicenter and intercultural studies may provide further information about cultural influences on SAD.

Interações virtuais e presenciais em universitários com e sem indicativo de fobia social

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Ansiedade social e cooperação em contexto de hierarquia social

The Ultimatum Game is a methodology of the Game Theory that intends to investigate the individuals cooperative behavior in situations of resources division. Studies have shown that half of the subjects don’t accept unfair division of resources, and prefer to bear a momentary cost to revenge the deceivers. However, people who have assertiveness impairment, such as social phobic individuals, could have some difficulties to reject unfair offer division resource, especially in situations that cause over anxiety, like being in the presence of an individual considered to be in a high hierarchical level. A negative perception about his own worth can also make the person thinks that he does not deserve a fair division. These individuals also have a strong desire to convey a positive impression to the others, which could cause them to be more generous in a resource division. The aim of this study was to verify, through the Ultimatum Game, if social anxiety individuals would accept more high confederate’s unfair offers that low confederate’s unfair offers; and if they would be more generous in goods division, in the same game, when compared to individuals without social anxiety. Ninety-five (95) college students participated in this study answering the Social Phobia Inventory, the Factorial Scale of Extroversion, socio-demographic questionnaire, situational anxiety scale and, finally, the Ultimatum Game in four rounds (1st and 3rd – confederate representing high or low ranking using an unfair proposal; 2nd – confederate without social status using fair proposal; 4th – subject’s research proposes the offer). The results showed a significant negative correlation between social anxiety and haughtiness, and social anxiety and assertiveness, and a significant positive correlation between social anxiety and situational anxiety. There was no significant difference in situational anxiety due to the status for anxious individuals. Also we found no significant difference in the amount of donated goods, showing that generous behavior does not differ between groups. Finally, the social status did not influence the decision in response to the game for anxious individuals. These results corroborate to other studies that show the relationship between social anxiety and assertiveness, and social anxiety and negative self-perception capability and value (low haughtiness). As show the results of situational anxiety scale, the high status stimulus was not perceived as threatening to the individual, which may have affected his answer in the game. The results for the Ultimatum Game follow the same direction as the acceptance rate for unfair proposals (approximately 50%) in studies with non-clinical sample.

Ansiedade social e cooperação em contexto de hierarquia social

The Ultimatum Game is a methodology of the Game Theory that intends to investigate the individuals cooperative behavior in situations of resources division. Studies have shown that half of the subjects don’t accept unfair division of resources, and prefer to bear a momentary cost to revenge the deceivers. However, people who have assertiveness impairment, such as social phobic individuals, could have some difficulties to reject unfair offer division resource, especially in situations that cause over anxiety, like being in the presence of an individual considered to be in a high hierarchical level. A negative perception about his own worth can also make the person thinks that he does not deserve a fair division. These individuals also have a strong desire to convey a positive impression to the others, which could cause them to be more generous in a resource division. The aim of this study was to verify, through the Ultimatum Game, if social anxiety individuals would accept more high confederate’s unfair offers that low confederate’s unfair offers; and if they would be more generous in goods division, in the same game, when compared to individuals without social anxiety. Ninety-five (95) college students participated in this study answering the Social Phobia Inventory, the Factorial Scale of Extroversion, socio-demographic questionnaire, situational anxiety scale and, finally, the Ultimatum Game in four rounds (1st and 3rd – confederate representing high or low ranking using an unfair proposal; 2nd – confederate without social status using fair proposal; 4th – subject’s research proposes the offer). The results showed a significant negative correlation between social anxiety and haughtiness, and social anxiety and assertiveness, and a significant positive correlation between social anxiety and situational anxiety. There was no significant difference in situational anxiety due to the status for anxious individuals. Also we found no significant difference in the amount of donated goods, showing that generous behavior does not differ between groups. Finally, the social status did not influence the decision in response to the game for anxious individuals. These results corroborate to other studies that show the relationship between social anxiety and assertiveness, and social anxiety and negative self-perception capability and value (low haughtiness). As show the results of situational anxiety scale, the high status stimulus was not perceived as threatening to the individual, which may have affected his answer in the game. The results for the Ultimatum Game follow the same direction as the acceptance rate for unfair proposals (approximately 50%) in studies with non-clinical sample.

Further psychometric study of the Beck Anxiety Inventory including factorial analysis and social anxiety disorder screening

Objective. To analyze the psychometric properties of the Brazilian Portuguese version of the Beck Anxiety Inventory (BAI) in terms of its internal consistency, scores distribution, concurrent and discriminant validity, and factorial analysis in a sample of university students and social anxiety disorder (SAD) cases and non-cases. Methods. A sample of Brazilian university students from the general population (N = 2314) and a sample of university students identified as cases (N = 88) and non-cases (N = 90) of SAD were assessed, using as a parameter the Structured Clinical Interview for the DSM-IV. The different instruments were completed individually in the presence of an experienced rater. Results. The BAI showed adequate internal consistency (0.88-0.92) and discriminant validity, with 0.74 sensitivity and 0.71 specificity for a cut-off score of 10. The factorial analysis suggested a three-factor solution to be the most adequate. Conclusions. The version of the BAI studied is quite adequate to be used in the context of Brazilian university students, identifying the presence of anxiety indicators. However, its usefulness to screen for SAD seems limited.

The Portuguese language version of social phobia and Anxiety Inventory: analysis of items and internal consistency in a Brazilian sample of 1,014 undergraduate students

OBJECTIVE: Theoretical and empirical analysis of items and internal consistency of the Portuguese-language version of Social Phobia and Anxiety Inventory (SPAI-Portuguese). METHODS: Social phobia experts conducted a 45-item content analysis of the SPAI-Portuguese administered to a sample of 1,014 university students. Item discrimination was evaluated by Student's t test; interitem, mean and item-to-total correlations, by Pearson coefficient; reliability was estimated by Cronbach's alpha. RESULTS: There was 100% agreement among experts concerning the 45 items. On the SPAI-Portuguese 43 items were discriminative (p < 0.05). A few inter-item correlations between both subscales were below 0.2. The mean inter-item correlations were: 0.41 on social phobia subscale; 0.32 on agoraphobia subscale and 0.32 on the SPAI-Portuguese. Item-to-total correlations were all higher then 0.3 (p < 0.001). Cronbach's alphas were: 0.95 on the SPAI-Portuguese; 0.96 on social phobia subscale; 0.85 on agoraphobia subscale. CONCLUSION: The 45-item content analysis revealed appropriateness concerning the underlying construct of the SPAI-Portuguese (social phobia, agoraphobia) with good discriminative capacity on 43 items. The mean inter-item correlations and reliability coefficients demonstrated the SPAI-Portuguese and subscales internal consistency and multidimensionality. No item was suppressed in the SPAI-Portuguese but the authors suggest that a shortened SPAI, in its different versions, could be an even more useful tool for research settings in social phobia.

Validation of the Social Phobia and Anxiety Inventory for Children (SPAI-C) in a sample of Brazilian children

The purpose of the present study was to examine the factor structure and psychometric properties of the Social Phobia and Anxiety Inventory for Children (SPAI-C), an instrument developed in the United States and applied to a sample of Brazilian schoolchildren. The process included the translation of the original material from English into Portuguese by two bilingual psychiatrists and a back translation by a bilingual physician. Both the front and back translations were revised by a bilingual child psychiatrist. The study was performed using a cross-sectional design and the Portuguese version of the SPAI-C was applied to a sample of 1954 children enrolled in 3rd to 8th grade attending 2 private and 11 public schools. Eighty-one subjects were excluded due to an incomplete questionnaire and 2 children refused to participate. The final sample consisted of 1871 children, 938 girls (50.1%) and 933 boys (49.8%), ranging in age from 9 to 14 years. The majority of the students were Caucasian (89.0%) and the remainder were African-Brazilian (11.0%). The Pearson product-moment correlation showed that the two-week test-retest reliability coefficient was r = 0.780 and Cronbach's alpha was 0.946. The factor structure was almost similar to that reported in previous studies. The results regarding the internal consistency, the test-retest reliability and the factor structure were similar to the findings obtained in studies performed on English speaking children. The present study showed that the Portuguese language version of SPAI-C is a reliable and valid measure of social anxiety for Brazilian children.