Can the Liebowitz Social Anxiety Scale - Self-Report Version Be Used to Differentiate Clinical and Non-Clinical SAD Groups among Brazilians?

Abstract

BackgroundThe Liebowitz Social Anxiety Scale (LSAS) was the first evaluation instrument developed for screening for the signs and symptoms of Social Anxiety Disorder (SAD) and is currently still the most used worldwide. The aim of this study is to evaluate the ability of the LSAS - self-report version (LSAS-SR) to discriminate different Social Anxiety Disorder (SAD) clinical groups.MethodThe sample was composed of Brazilians university students, allocated into three different groups, i.e., cases (C=118), non-cases (NC=95) and subclinical cases (SC=39). To achieve the aim, calculations of the ROC Curve and ANOVA were performed.ResultsThe results found were excellent regardless of the technique used, highlighting the discriminatory capacity of the LSAS-SR. The score equal to or greater than 32 is suggested as a cutoff score for the Brazilian population, since this presented balance between the standards evaluated and the ability to differentiate both clinical and subclinical SAD cases from non-cases.ConclusionDespite the specific sample used in this study being composed only of university students, the use of the LSAS-SR can be indicated, in the Brazilian setting, for SAD screening in both clinical and research contexts.

Liebowitz Social Anxiety Scale (LSAS): Optimal cut points for remission and response in a German sample

“…Second, the best balance between sensitivity and specificity was achieved for remission by using a cut point of 30 for the CA and 35 for the SR version of the German LSAS. These results are close to the cut points reported in former studies (Bandelow et al, ; Mennin et al, ; Rytwinski et al, ; Santos et al, ). We suggest using the OCs that maximize both sensitivity and specificity, because they provide the best balance between correct identification of people suffering from SAD and misclassification of those who do not.…”

“…First, the overall high values are in line with previous studies. Although there are many studies showing that the LSAS can be used to detect patients with SAD (e.g., Mennin et al, ; Rytwinski et al, ; Santos et al, ), there is essentially only one study into the utility to monitor progress during therapy (Bandelow et al, ). Our findings expand this study by first showing that the LSAS can also be used in a German sample.…”

“…Importantly, our findings concerning the variability show for the first time that some of the differences in reported cut points may be attributed to random fluctuations, due to the estimation of the OC rather than systematic differences between the underlying samples. For example, Rytwinski et al () identified an OC of 30 to detect SAD, whereas the study of Santos et al () found an OC of 32. Both of these cut points are within the range of our bootstrapping results (see Table ).…”

“…Although there are many studies showing that the LSAS can be used to detect patients with SAD (e.g., Mennin et al, 2002;Rytwinski et al, 2009;Santos et al, 2015), there is essentially only one study into the utility to monitor progress during therapy (Bandelow et al, 2006).…”

“…Previous receiver operating characteristics (ROC) analyses of the LSAS found that the optimal cut point (OC) to differentiate between individuals with and without SAD was about 30 (Bandelow et al, ; Mennin et al, ; Rytwinski et al, ; Santos, Loureiro, Crippa, & Osório, ). However, studies in different cultural backgrounds identified cut points as low as 19.6 (Bobes et al, ) and as high as 41/42 (Kummer, Cardoso, & Teixeira, ) as optimal.…”