The Liebowitz Social Anxiety Scale for Children and Adolescents: An Initial Psychometric Investigation

New York University School of Medicine, Child Study Center, New York, NY 10016, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 10/2003; 42(9):1076-84. DOI: 10.1097/01.CHI.0000070249.24125.89
Source: PubMed


To examine the psychometric properties of a newly developed clinician rating scale, the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA).
A total of 154 children and adolescents participated in an assessment consisting of a diagnostic interview, the LSAS-CA, and other measures of psychopathology and impairment. Sixty-one of these children also participated in a second LSAS-CA administration, by a different rater blind to diagnosis, within 7 days of the initial assessment.
High internal consistency (alpha =.90-.97 for full sample and.83-.95 for social phobia group) and test-retest reliability (intraclass correlation coefficient = 0.89-0.94) were obtained for LSAS-CA total and subscale scores. LSAS-CA scores had stronger associations with measures of social anxiety and general impairment than with a measure of depression. Subjects with social anxiety disorder had significantly higher LSAS-CA scores than subjects with other anxiety disorders and healthy controls. A LSAS-CA cutoff score of 22.5 represented the best balance of sensitivity and specificity when distinguishing between individuals with social phobia and normal controls, whereas a cutoff of 29.5 was optimal for distinguishing social phobia from other anxiety disorders.
Initial findings suggest that the LSAS-CA is a reliable and valid instrument for the assessment of social anxiety disorder.

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    • "Liebowitz Social Anxiety Scale for Children and Adolescents (Masia-Warner et al., 2003): It is used to assess the severity of SP. The scale assesses the range of social interaction and performance in situations that may cause individuals with social anxiety to fear and/or to avoid. "
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    ABSTRACT: The aim of this study was to assess the response of social phobia (SP) symptoms to methylphenidate (MPH) treatment in children with attention deficit hyperactivity disorder (ADHD). Twenty-one ADHD patients with SP, aged between 8 and 18 years, received 12 weeks of MPH treatment. The severity of SP symptoms were assessed by the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA), and the severity of ADHD symptoms was assessed by the ADHD Rating Scale at baseline and at endpoint. MPH treatment was associated with a significant decrease in the ADHD Rating Scale scores (P<0.0001) and in the total LSAS-CA scores (P=0.013), as well as the school-related items of LSAS-CA (P=0.011). A significant correlation was found between the reductions in ADHD score and total LSAS-CA score (P=0.038), especially in school-related SP. The improvement in ADHD symptoms because of MPH treatment correlates with a parallel improvement in SP. MPH treatment appears to be safe and effective in ADHD/SP children.
    International clinical psychopharmacology 01/2014; 29(4). DOI:10.1097/YIC.0000000000000029 · 2.46 Impact Factor
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    • "The demographic data and non-psychiatric medical history records, including the body mass index (BMI), relied on self-report interviews vouched by the parents. The psychological assessment included the following instruments: the McCrae and Costa' BigFive [17], a 44-item self-report inventory designed to measure the Big Five dimensions, consisting of short phrases with relatively accessible vocabulary; the Eating Disorders Inventory (EDI), a self-report questionnaire used to assess the presence of eating disorders (EDs) (submitted alongside with the SCID-I module for EDs), (a) Anorexia nervosa both restricting and binge-eating/purging type; (b) Bulimia nervosa; and (c) eating disorder not otherwise specified including binge eating disorder (BED), including 64 questions, divided into eight subscales [18,19], Bisantis's Assertivity test, a 20-item, multiple choice questionnaire aimed at measuring one's assertivity, defined as ‘the ability to recognize and express his/her own emotions, to claim his/her own rights, and to manifest his/her own needs, preferences, desires and critics’ [20] and the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA-SR), a 24-item scale descripting 12 social interactions and 12 performance situations [21]. "
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    ABSTRACT: Adolescence represents one of the critical transitions in the life span and is characterized by a tremendous pace in growth and change that is second only to that of infancy. Both biological and psychological changes occurring during early adolescence may also influence the definition of subsequent late adolescence or early adulthood physiological or (psycho)-pathological features, including bulimia nervosa (BN) whenever occurring. Therefore, a pre-emptive assessment of suggestive psychological traits, including bulimic ones, during early and late years of adolescence, is recommended and represents the goal of the present study. Six hundred and eight healthy volunteers attending mid- or high school, aged 14--19 years, were consecutively enrolled at multiple sites in Eastern Sicily, Italy. A systematic psychological assessment was performed, including McCrae and Costa' BigFive, the Eating Disorders Inventory (EDI), Bisantis's Assertivity test and the Liebowitz Social Anxiety Scale for Children and Adolescents. Demographic and general characteristics, including the body mass index, were also recorded. Based on hierarchical considerations, cases were then divided into 'younger' ('early' years, 14--16) and 'older' ('late' years, 17--19) adolescents. Upon descriptive and Pearson's correlation analyses, the following EDI constructs 'drive to thinness' and 'bulimia' scored significantly higher (both p = <.001) in 'early' vs. 'late' cases. Conversely, BigFive 'conscientiousness' was higher in older subjects vs. early cases (p = <.003). As expected, 'drive to thinness' positively correlated with BN both in early (r = .31) and late (r = .50) cases. In the 'late' group, age correlated with conscientiousness (r = .206) while BN correlated with drive to thinness (r = .505); finally, a negative correlation was observed with regard to consciousness and BN (r = -.19). Despite intrinsic methodological limits, our preliminary findings confirm that the transition between early and late years of adolescence is a critical phase of life span, with the consolidation of 'conscientiousness' eventually playing a protective role towards the onset of bulimic traits. If confirmed by replication studies, ideally providing long-term follow-ups too, an early acknowledgement of bulimic traits may play a major predictive role for subsequent BN, ultimately contributing to more effective pre-emptive interventions as well.
    Annals of General Psychiatry 10/2013; 12(1):34. DOI:10.1186/1744-859X-12-34 · 1.40 Impact Factor
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    • "The aim of this study was double: to explore the psychometric properties of the LSAS [Liebowitz, 1987] in the adolescent population, but also to analyze the score distribution. Most studies on the psychometric characteristics of the LSAS involved adult samples [Bobes et al., 1999; Heimberg et al., 1999; Levin et al., 2002; Safren et al., 1999] and very few used adolescent samples [Masia-Warner et al., 2003]. This highlights the need to explore the psychometric properties of this instrument regarding the adolescent population. "
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    ABSTRACT: Social phobia is an excessive concern about scrutiny by other people in situations the person considers embarrassing or humiliating. The purpose of this study is to explore the factor structure, reliability, and validity of the social fear and social avoidance subscales of the Liebowitz Social Anxiety Scale (LSAS) and to analyze the score distribution of both subscales. To this end, we assessed a sample of 1,012 Spanish adolescents attending school. The results of a first-order factor analysis indicate the existence of a dominant factor in both subscales of the LSAS--as well as three other less relevant factors--and explain most of the variance of the subscales. The internal consistency of the first factor was quite high in both subscales. The LSAS and its two subscales showed adequate theoretical validity with different variables related to social interaction. Finally, the different scores obtained in both subscales make it possible to group adolescents into three clusters with different characteristics. A study of the sociodemographic variables of the components of the clusters showed a significant relation only with sex.
    Depression and Anxiety 11/2008; 25(11):977-87. DOI:10.1002/da.20404 · 4.41 Impact Factor
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