بررسی ویژگی های روان سنجی پرسشنامه هراس اجتماعی در دانشجویان دانشگاه

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.

Social phobia (SP) or social anxiety disorder is a highly prevalent psychiatric disorder that courses with significant rates of comorbidity, with a negative influence of several aspects of life such as work and social, family, and affective relations, among others. Although potentially treatable, this condition is poorly recognized, with a consequent difficulty in the application of therapeutic measures that lead to a more reserved prognosis [1], [2], [3], [4], [5] and [6]. Many instruments of self- and hetero-assessment have been proposed to favor the diagnosis of SP because it was recognized as a psychiatric disorder in Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) in 1980 [6]. Particularly important among these instruments is the Social Phobia Inventory (SPIN) proposed by Connor et al [7]. This instrument, originally elaborated in the English language and consisting of 17 items that assess different aspects related to SP (fear, avoidance, and physiologic symptoms), is being extensively used in empirical and clinical studies. It has attracted the interest of several groups, with the consequent need to translate, adapt, and evaluate it for use in other contexts and cultures different from the original ones. The main findings regarding the psychometric qualities of the SPIN in different studies including the original study by Connor et al [7] are summarized in Table 1. Table 1. Psychometric studies conducted with the SPIN in different contexts and on different samples: main results Aspect evaluated Study Connor et al [7] Vilete [8] Johnson et al [9] Antony et al [10] Radomsky et al [11] Ranta et al [12] Objective To investigate psychometric properties—original English version To investigate psychometric properties—Brazilian version To investigate psychometric properties—original version To investigate psychometric properties—original version To investigate psychometric properties—original and French versions To investigate psychometric properties—Finnish version Sample studied Healthy adults and adults with SP—United States Healthy adolescents—Brazil Healthy adolescents—United States Adults with different anxiety disorders—Canada General population of college students—Canada Healthy adolescents—Finland Internal consistency α = .57-.94 α = .88 α = .69-.92 α = .79-.92 α = .76-.93 – Reliability T/R = 0.78-0.89⁎ T/R = 0.32-0.65⁎ – T/R = 0.78-0.84⁎⁎ T/R = 0.71-0.86⁎⁎ – Concurrent validity BSPS = 0.47-0.82⁎⁎ LSAS = 0.55⁎⁎ FQ = 0.42-0.78⁎⁎ – SAS-A = 0.57-0.82⁎⁎ SPAI-C = 0.71-0.91⁎⁎ SPS = 0.61-0.71⁎⁎ SIAS = 0.23-0.68⁎⁎ FSS-III = 0.56-0.76⁎⁎ – Divergent validity SF-36 = (NS) SDS = (NS) – CDI = 0.45-0.58⁎ DASS = (NS) ASI = (NS) BDI = 0.43-0.51⁎⁎ – Discriminative validity AUC = 0.83-0.86⁎ Cutoff note 19 S = 0.78 E = 0.84 Cutoff note 19/20 S = 0.75 E = 0.57 SP > control score AUC = 0.81⁎ Cutoff note 21: S = 68.3%; Sp = 81.4% SP > score OCD/agoraphobia Posttreatment score < pretreatment score – SP > non-SP score AUC = 0.92-0.82 Cutoff note 19: S = 0.95; E = 0.70; PPV = 0.40 Cutoff note 24: S = 0.81; Sp = 0.85; PPV = 0.26; NPV = 0.98 Factorial analysis 5 factors Autovalues: 1.06-5.51 – – – – – (NS) indicates nonsignificant correlation; S, sensitivity; Sp, specificity; PPV, positive predictive value; NPV, negative predictive value; AUC, area under the ROC curve; T/R, test-retest; LSAS, Liebowitz Social Phobia Scale; FQ, Fear Questionnaire; SF-36, Medical Outcomes Study Short-Form; SDS, Sheehan Disability Scale; SAS-S, Social Anxiety Scale for Adolescents; SPAI-C, Social Phobia and Anxiety Inventory for Children; CDI, Children's Depression Inventory; SPS, Social Phobia Scale; SIAS, Social Interaction Anxiety Scale; DASS, Depression Anxiety Stress Scales; ASI, Anxiety Sensitivity Index; FSS-III, Fear Survey Schedule-III; BDI, Beck Depression Inventory; OCD, obsessive-compulsive disorder. ⁎ P < .05. ⁎⁎ P < .01. Table options Table 1 indicates that the SPIN has shown quite acceptable psychometric properties both in validity and reliability in the various samples and contexts in which it has been evaluated. For use in Brazil, we point out the study of Vilete [8], which, due to the specificity of the sample studied (adolescents), required adaptations to the original version that were incorporated into the version studied. This adapted version, although potentially adequate for use within the specific context of adolescents, still needs better psychometric detailing. In view of these aspects and of the need for a version to be used for the adult population, with the authorization of the authors of the original instrument, Osório et al [13] proposed a new version of the SPIN to be used for adult Brazilian population. This instrument was evaluated by the authors in technical aspects and considered to be the official version for the Brazilian Portuguese language. A recent study conducted in Brazil on a sample of university students and of the general population regarding the analysis of the items and of the internal consistency of the SPIN [14] indicated quite promising results, stimulating the continuation of the psychometric study of such version, which is reported in the present article. This, our objective, was to analyze the psychometric properties of the SPIN in the Brazilian Portuguese version regarding concurrent/divergent validity, discriminative validity, construct validity, and factorial analysis. The study was conducted separately on 2 samples of Brazilian university students: one from the general population (phase 1) and one consisting of university students identified as SP cases and noncases (phase 2).

In general, the version of the SPIN for the population of Brazilian university students showed excellent psychometric qualities in all aspects evaluated, in agreement with both the original study of the instrument and with other studies conducted on different age ranges and in diverse cultural contexts. Thus, the potential of the scale for the assessment of relevant aspects concerning SP in the Brazilian context was demonstrated, as also shown for other cultures, favoring the use of the instrument in clinical and applied studies with a transcultural approach. The availability of this instrument for use in the adult population of Brazilian university students after rigorous calibration fills an important gap because by the time the present study was started, no specific instruments were available for the assessment and measurement of SP, with psychometric qualities extensively calibrated and validated. Future studies assessing the predictive validity of the SPIN are considered to be necessary and opportune.