The aim of the study was to explore the associations between the presence of avoidant personality problems (APPs) and 5 areas of impairment: demography, somatic issues, mental health, lifestyle, and social issues.
Avoidant personality problem was defined by confirmation of the 2 avoidant personality disorder items of the Iowa Personality Disorder Screen and and the Social Phobia Inventory (SPIN) short version (MINI-SPIN) screening assessment for generalized social anxiety disorder sum score of 6 or more. The questionnaires were administered in a Norwegian population survey (the Oslo Health Study-HUBRO). Cases consisted of 280 individuals with APP and 5 randomly selected controls without APP (n = 1400).
The APP group more frequently reported living alone, lower level of education, and lower income than controls. Poor self-rated health, presence of somatic disease, muscular pain, frequent use of analgesics, and visits at a general practitioner were significantly more common in the APP group than among controls. The APP group had significantly higher proportion of caseness of mental distress, low general self-efficacy, and insomnia, and this result held up in multivariate analyses. The APP group showed statistically significant higher proportions of physical inactivity, obesity, daily smoking, and alcohol problems compared with controls. As for social impairment, a significantly higher proportion of the APP group reported "not having enough good friends," "high powerlessness," and low community activism, and the 2 former variables held up in multivariate analyses.
In this population-based study, we found that high levels of APP, defined closely to avoidant personality disorder, were significantly associated with demographic, somatic, and mental impairment; low general self-efficacy; and insomnia affecting work ability. In addition, APP showed associations with negative lifestyle, alcohol problems, and social impairment reporting lack of good friends and lack of empowerment. Avoidant personality problem is associated with clinically significant impairment in several areas, which underlines the importance of recognizing these problems in primary health care.
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.
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.
Item versions were highly correlated and scores did not differ statistically. The two items' correlations with other measures did not differ statistically either.
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.
Cites: Behav Res Ther. 1998 Apr;36(4):455-709670605
BACKGROUND: Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. METHODS: Subjects (Ss) were consecutive specialist clinic patients, 16 men, 14 women, 20-65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. RESULTS: Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9) with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment intensity ratings were positively correlated with years of avoidance and degree of mouth-hiding behaviors. CONCLUSIONS: Embarrassment is a complex dental anxiety manifestation with qualitative differences by complaint characteristics and perceived intensity. Some cases exhibited manifestations similar to psychiatric criteria for social anxiety disorder as chief complaint, while most manifested embarrassment as a side effect.
Schools are among the most important setting for preventive interventions among adolescents. There are evidence-based intervention programs for adolescents at risk for and with early signs of mental health problems but one demanding task is to detect the ones who are in need of an intervention. The aim of the present study was to analyze associations between self-esteem, depressive symptoms, and social anxiety in order to determine clinically relevant cut-points for male and female adolescents' self-esteem as measured with the Rosenberg Self-Esteem Scale (RSES). The participants of the present prospective study, started in 2002-2003, were 2070 adolescents aged 15 years (1,167 girls and 903 boys) at two study sites in Finland who participated at both baseline and 2-year follow-up. Self-esteem was related to depressive symptoms and social anxiety, and the RSES was able to discriminate between cases of depression and social phobia. The present study suggests a cutoff of 25 points to classify low self-esteem in both girls and boys. Low self-esteem may function as an indicator of various forms of internalizing psychopathology. The RSES is worth further examination as a potential screening tool for adolescents in risk of psychopathology.
This study aims to examine the reliability and validity of the French version of the Dominic Interactive screening tool (Valla, 2008) among Indigenous children in Quebec. The Dominic Interactive is a computerized screening tool, which assesses prevalent emotional and behavioral problems in children. Participants in this study were 195 Innu Nation children aged between 8 and 11 years. Statistical analyses were performed on each of the 7 scales of the Dominic Interactive to assess reliability, factor structure, and measurement invariance across boys and girls. Results show satisfactory reliability (ranging from atet = .83 to .94 and from ? = .84 to .95) for 5 out of the 7 scales scores. Separation Anxiety and Specific Phobias scales failed to show adequate reliability. Confirmatory factor analyses confirm the 1-factor structure for Opposition and Conduct Problems scales (root mean square error of approximation, RMSEA = .05; comparative fit index, CFI = .95). Within an exploratory framework, confirmatory factor analyses also show good fit indices of relaxed models for Inattention/Hyperactivity/Impulsivity, Depression, and Specific phobias, admitting some error correlations. Generalized anxiety had poorer model fits; factor structure is not confirmed for this scale. The Separation anxiety construct appears to be better described by a 2-factor structure than by the postulated 1-factor structure. Measurement invariance between boys and girls was sufficiently supported for most of the scales, except for Specific Phobias. Therefore, results demonstrate promising reliability and validity for scales evaluating behavioral problems and depressive symptoms, but further research is still needed to determine the generalizability of these exploratory results in Indigenous populations. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
The aim of the present study was to analyse the longitudinal concomitants of incorrect weight perception, depressive symptoms, social anxiety, self-esteem, and eating disorders in adolescents. A prospective follow-up study on 283 female and 312 male adolescents aged 15 comprising questionnaires directed at the whole study population and subsequent personal interviews with adolescents found to be screen-positive for eating disorders, at both baseline and three-year follow-up. Body mass index was combined with weight perception to classify adolescents with incorrect weight perception. Twenty-nine percent of females incorrectly perceived themselves as overweight and 14% of males incorrectly as underweight. Incorrect weight perception was in females related to depressive symptoms, social anxiety, eating disorders, and low self-esteem. Males with incorrect weight perception experienced more social anxiety at the follow-up than their counterparts with correct weight perception. Recognition of incorrect weight perception is important for prevention of depression, social anxiety, and eating disorders.
In a previous study (Cox, Swinson, Kuch & Reichman, Behaviour Research and Therapy, 31, 427-431, 1993), factor analyses of the responses of 177 Canadian panic disorder with agoraphobia patients to the 'When Accompanied' and 'When Alone' scales of the Mobility Inventory (Chambless, Caputo, Jasin, Gracely & Williams, Behaviour Research and Therapy, 23, 35-44, 1985) revealed three factors in each case: Fears of (1) Public places; (2) Enclosed spaces; and (3) Open spaces. Using two distinct methods of factorial analysis, evidence was found for the cross-national generalizability of the factor model when the responses of Dutch members of a society for individuals suffering from an anxiety disorder (N = 213) were contrasted with the original Canadian findings. Inventory items were distributed in a non-overlapping fashion across the corresponding three subscales. Psychometric properties of the subscales were encouraging, although some difficulties emerged when attempts were made at distinguishing Fears of Enclosed spaces from Fears of Open spaces. This was because of their correlational configurations with other measures. Scores on all scales varied with socioeconomic status (SES); Ss in lower SES groups had significantly higher agoraphobic avoidance scores than their equivalents in higher SES groups. Results of higher-order analysis, which included several state and trait measures of psychological functioning in addition to the Mobility Inventory, revealed two orthogonal, second-order factors which were interpreted as Agoraphobia and Neuroticism/Negative Affect vs Positive Affect. Implications for further studies are briefly outlined.
Research designed to determine the number and kind of dimensions underlying self-reports of animal fears is relatively rare. To contribute further knowledge to this area of study, Davey's methodology [Davey, G. C. L. (1994a). Self-reported fears to common indigenous animals in an adult UK population: the role of disgust sensitivity. British Journal of Psychology, 85, 541-554.] was improved. Principal components analysis with Varimax rotation of the self-ratings to items of Davey's Animal Fears Questionnaire returned by Ss from a Dutch community sample (N = 214) revealed four reliable, relatively independent dimensions: (1) fear-relevant animals, (2) dry or non-slimy invertebrates, (3) slimy or wet looking animals and (4) farm animals. Replicating Davey (1994a), females, relative to males, reported higher levels on most fear items. Principal components analysis with Oblimin rotation involving animal fears scales (derived from the dimensions identified in the present study), dimensions of non-animal fears, disgust sensitivity, sex-role orientation and the major dimensions of personality from the Eysenckian system revealed 4 higher-order factors, namely specific animals fears, positive affectivity, toughmindedness and negative affectivity. At an even higher level, these 4 higher-order factors merged into two factors: (1) a bipolar positive affectivity versus neuroticism/general emotionality/negative affectivity factor and (2) a toughmindedness dimension. Studies such as these contribute in helping provide the elements of the hierarchical model of fears proposed by Taylor [Taylor, S. (1998). The hierarchic structure of fears. Behaviour Research and Therapy, 36, 205-214.]. Findings across different studies suggest that there are at least 5 first-order dimensions of animal fears, the above 4 and predatory (fierce) animals, that may be included in such a model.
The study evaluated the psychometric properties of Finnish versions of the Social Phobia and Anxiety Inventory for Children (SPAI-C) and the Social Anxiety Scale for Children-Revised (SASC-R). 352 students (M = 12.2 years) participated in the study and completed the SPAI-C and SASC-R. In addition, 68 participants (M = 12.2 years) and their parents were interviewed with the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS-PL). The SPAI-C was more sensitive for identifying youth meeting criteria for social phobia (SP), whereas the SASC-R demonstrated greater specificity. The youth in this sample had lower mean total scores on the self-report questionnaires than did those in the original validitation studies of the SPAI-C and SASC-R conducted in America. These findings question whether cross-cultural differences in the expression of SP influence the clinical cut-off scores used in translated versions of social anxiety questionnaires.
The social phobia and anxiety inventory for children (SPAI-C) is a 26 item, empirically derived self-report instrument developed for assessing social phobic fears in children. Evidence for satisfactory psychometric properties of the SPAI-C has been found in multiple community studies. Since its development, however, no study has presented an extensive psychometric evaluation of SPAI-C in a sample of carefully diagnosed children with social phobia. The present study sought to replicate and expand previous studies by administrating the SPAI-C to a sample of 59 children that fulfilled DSM-IV criteria for social phobia, and 49 children with no social phobia diagnosis. An exploratory factor analysis resulted in a three factor solution reflecting: (1) fear of social interactions, (2) fear of public performance situations, and (3) physical and cognitive symptoms connected with social phobia. These factors appear to parallel domains of social phobia also evident in adults. The SPAI-C total scale and each factor was found to possess good internal consistency, good test-retest reliability and was generally strongly correlated with both self-report and clinician measures of anxiety and fears. The discriminative properties of the total scale were satisfactory.