Social Anxiety Disorder: validation of assessment instruments. / Transtorno de ansiedade social: validação de instrumentos de avaliação

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Social Anxiety Disorder (SAD) is a condition of early onset and of significant prevalence and comorbidity, greatly impairing the functioning of young people in terms of job, family, social life and academic performance. In view of these characteristics, an early identification and precise diagnosis of SAD are necessary, requiring validated instruments. The objective of the present study was to perform a systematic evaluation of SAD by means of a set of instruments tested in a population of young Brazilian adults, college students, from the perspective of self- and hetero-evaluation. For this purpose, transcultural validation was performed of the self-evaluation instruments Social Phobia Inventory (SPIN) and Self Statements During Public Speaking Scale (SSPS trait and state version) and of the hetero-evaluation instrument Brief Social Phobia Scale (BSPS), after approval by the authors of the original versions. The methodological design involved three stages. In the first, the sample used for evaluation of the SPIN and SSPS instruments consisted of 2314 college students from the general population. In the second stage, a sample of 178 college students identified as cases (N = 88) and non-cases (N = 90) of SAD, confirmed by the Structured Clinical Interview for DSM-IV (SCID-IV) was used for the evaluation of the SPIN, SSPS and BSPS instruments. In the third stage, 45 college students, also classified as cases (N = 24) and non-cases (N = 21) of SAD, formed the sample for the evaluation of the SSPS-state within the context of an experimental public speaking model. SPIN presented good internal consistency ( = 0,63-0,90), validity in agreement with the Beck Anxiety Inventory (BAI) (r = 0,10-0,63) and SSPS-trait (r = 0,22-0,65), discriminative validity (sensitivity = 0,84, specificity = 0,87) and construct validity. Factorial analysis indicated the presence of a variable number of factors as a function of the sample studied. The reduced version of this instrument, the Mini-SPIN, is emphasized, also presenting excellent psychometric indicators (sensitivity = 0,77, specificity = 0,67). SSPS-trait proved to be quite adequate regarding internal consistency ( = 0,64-0,94), validity in agreement with the BAI (r = 0,18-0,53) and SPIN (r = 0,22-0,65), and discriminative validity between cases and non-cases of SAD. Factorial analysis demonstrated the presence of two factors, i.e., positive and negative self-evaluation. The BSPS applied with the support of a guidingquestion list, presented excellent inter-rater reliability (0,86-1,00) and discriminative validity (sensitivity = 0,84, specificity = 0,83), adequate internal consistency ( = 0,48- 0,88), validity in agreement with the BAI (r = 0,21-0,62), SPIN (r = 0,24-0,82) and SSPStrait (r = 0,23-0,31), and construct validity. Factorial analysis indicated the presence of six factors that explained 71,8% of the variance of the data. The SSPS-state proved to be appropriate for the evaluation of cognitive aspects associated with public speaking, presenting excellent discriminative validity between cases and non-cases of SAD, as well as sensitivity in the discrimination of the different levels of anxiety during the phases of the procedure. All instruments showed good psychometric qualities, a fact that recommends their use in the population of Brazilian college students, with the possibility of application both in the clinical and experimental context, favoring a more precise detection of SAD, especially within the context of primary health care.

ASSUNTO(S)

scales validity public speaking social anxiety falar em público escalas fidedignidade ansiedade social reliability validade

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