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Assessment of Social Anxiety in First Episode Psychosis using the Liebowitz Social Anxiety scale as a Self-report Measure

Published online by Cambridge University Press:  30 October 2010

K.L. Romm ,
J.I. Rossberg ,
A.O. Berg ,
C.F. Hansen ,
O.A. Andreassen  and
I. Melle
K.L. Romm*
Affiliation:
Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, 0407Oslo, Norway
J.I. Rossberg
Affiliation:
Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, 0407Oslo, Norway Institute of Clinical Medicine, Section of Psychiatry, University of Oslo, 0318Oslo, Norway
A.O. Berg
Affiliation:
Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, 0407Oslo, Norway
C.F. Hansen
Affiliation:
Department of Psychology, University of Oslo, Pb. 1094 Blindern, 0317Oslo, Norway
O.A. Andreassen
Affiliation:
Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, 0407Oslo, Norway Institute of Clinical Medicine, Section of Psychiatry, University of Oslo, 0318Oslo, Norway
I. Melle
Affiliation:
Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, 0407Oslo, Norway Institute of Clinical Medicine, Section of Psychiatry, University of Oslo, 0318Oslo, Norway
*
⁎Corresponding author. E-mail address: k.l.romm@medisin.uio.no (K.L. Romm).
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Abstract

Objective

Social anxiety is a common problem in psychotic disorders. The Liebowitz Social Anxiety Scale, Self-Rating version (LSAS-SR) is a widely used instrument to capture different aspects of social anxiety, but its psychometric properties have not been tested in this patient group. The aims of the present study were to evaluate the psychometric properties of the LSAS-SR in patients with first episode psychosis, to investigate whether it differentiated between active and passive social withdrawal and to test which clinical factors contributed to current level of social anxiety.

Method

A total of 144 first episode psychosis patients from the ongoing Thematically Organized Psychosis (TOP) study were included at the time of first treatment. Diagnoses were set according to the Structured Clinical Interview (SCID-1) for DSM-IV. A factor analysis was carried out and the relationship of social anxiety to psychotic and general symptomatology measured by the Positive and Negative Syndrome Scale (PANSS) was evaluated. Possible contributors to social anxiety were analyzed using multiple hierarchic regression analysis.

Results

The factor analysis identified three subscales: public performance, social interaction and observation. All three subscales showed satisfactory psychometric properties, acceptable convergent and discriminate properties, and confirmed previous findings in social anxiety samples. Self-esteem explained a significant amount of the variance in social anxiety, even after adjusting for the effects of delusions, suspiciousness and depression.

Conclusion

The study shows that the LSAS-SR can be used in this patient group, that social anxiety is strongly related to both behavioral social avoidance and to self-esteem. The results support the use of this measure in assessment of social anxiety in both clinical settings and in research.

Keywords

First episode psychosisSchizophreniaSocial phobiaSocial anxietyLiebowitz Social Anxiety Scale
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 2 , March 2011 , pp. 115 - 121
Copyright
Copyright © Elsevier Masson SAS 2010

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References

Addington, D.Addington, J.Schissel, B.A depression rating scale for schizophrenics. Schizophr Res 341990; 247-251CrossRefGoogle ScholarPubMed
American Psychiatric Association Diagnostic and statistical manual of mental disorders DSM IV 4th ed. American Psychiatric Association Washington DC, 1994Google Scholar
Baker, S.L.Heinrichs, N.Kim, H.J.Hofmann, S.G.The liebowitz social anxiety scale as a self-report instrument: a preliminary psychometric analysis. Behav Res Ther 4062002; 701-715CrossRefGoogle ScholarPubMed
Bentsen, H.Munkvold, O.G.Notland, T.H.Boye, B.Bjorge, H.Lersbryggen, A.B., et al.The interrater reliability of the Positive and Negative Syndrome Scale (PANSS). Int J Methods Psychiatr Res 641996; 227-2353.3.CO;2-A>CrossRefGoogle Scholar
Birchwood, M.Pathways to emotional dysfunction in first-episode psychosis. Br J Psychiatry 18252003; 373-375CrossRefGoogle ScholarPubMed
Birchwood, M.Trower, P.Brunet, K.Gilbert, P.Iqbal, Z.Jackson, C.Social anxiety and the shame of psychosis: a study in first episode psychosis. Behav Res Ther 2006; 25: 1025–1037Google Scholar
Brown, E.J.Juster, H.R.Heimberg, R.G.Winning, C.D.Stressful life events and personality styles: relation to impairment and treatment outcome in patients with social phobia. J Anxiety Disord 1231998; 233-251CrossRefGoogle ScholarPubMed
Cosoff, S.J.Hafner, R.J.The prevalence of co-morbid anxiety in schizophrenia, schizoaffective disorder and bipolar disorder. Aust N Z J Psychiatry 3211998; 67-72CrossRefGoogle Scholar
Cox, B.J.Ross, L.Swinson, R.P.Direnfeld, D.M.A comparison of social phobia outcome measures in cognitive-behavioral group therapy. Behav Modif 2231998; 285-297CrossRefGoogle ScholarPubMed
Fenton, W.S.Depression, suicide, and suicide prevention in schizophrenia. Suicide Life Threat Behav 3012000; 34-49Google Scholar
Fresco, D.M.Coles, M.E.Heimberg, R.G.Liebowitz, M.R.Hami, S.Stein, M.B., et al.The Liebowitz Social Anxiety Scale: a comparison of the psychometric properties of self-report and clinician-administered formats. Psychol Med 3162001; 1025-1035CrossRefGoogle ScholarPubMed
Gumley, A.O’Grady, M.Power, K.Schwannauer, M.Negative beliefs about self and illness: a comparison of individuals with psychosis with or without comorbid social anxiety disorder. Aust N Z J Psychiatry 3811–122004; 960-964CrossRefGoogle ScholarPubMed
Halperin, S.Nathan, P.Drummond, P.Castle, D.A cognitive-behavioural, group-based intervention for social anxiety in schizophrenia. Aust N Z J Psychiatry 3452000; 809-813CrossRefGoogle Scholar
Hansen, C.F.Torgalsboen, A.K.Melle, I.Bell, M.D.Passive/apathetic social withdrawal and active social avoidance in schizophrenia: difference in underlying psychological processes. J Nerv Ment Dis 19742009; 274-277CrossRefGoogle ScholarPubMed
Holt, C.S.Heimberg, R.G.Hope, D.A.Liebowitz, M.R.Situational domains of social phobia. J Anxiety Disord 611992; 63-77CrossRefGoogle Scholar
Karatzias, T.Gumley, A.Power, K.O’Grady, M.Illness appraisals and self-esteem as correlates of anxiety and affective comorbid disorders in schizophrenia. Compr Psychiatry 4842007; 371-375CrossRefGoogle Scholar
Kay, S.R.Fiszbein, A.Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1321987; 261-276CrossRefGoogle Scholar
Kingsep, P.Nathan, P.Castle, D.Cognitive behavioural group treatment for social anxiety in schizophrenia. Schizophr Res 631–22003; 121-129CrossRefGoogle Scholar
Kobak, K.A.Schaettle, S.C.Greist, J.H.Jefferson, J.W.Katzelnick, D.J.Dottl, S.L.Computer-administered rating scales for social anxiety in a clinical drug trial. Depress Anxiety 731998; 97-1043.0.CO;2-2>CrossRefGoogle Scholar
Lecrubier, Y.Wittchen, H.U.Faravelli, C.Bobes, J.Patel, A.Knapp, M.A European perspective on social anxiety disorder. Eur Psychiatry 1512000; 5-16CrossRefGoogle ScholarPubMed
Liebowitz, M.R.Social phobia. Mod Probl Pharmacopsychiatry 1987; 22: 141–173CrossRefGoogle ScholarPubMed
Liebowitz, M.R.Schneier, F.Campeas, R.Hollander, E.Hatterer, J.Fyer, A., et al.Phenelzine vs atenolol in social phobia. A placebo-controlled comparison. Arch Gen Psychiatry 4941992; 290-300CrossRefGoogle ScholarPubMed
Lysaker, P.H.Hammersley, J.Association of delusions and lack of cognitive flexibility with social anxiety in schizophrenia spectrum disorders. Schizophr Res 861–32006; 147-153CrossRefGoogle ScholarPubMed
Lysaker, P.H.Salyers, M.P.Anxiety symptoms in schizophrenia spectrum disorders: associations with social function, positive and negative symptoms, hope and trauma history. Acta Psychiatr Scand 11642007; 290-298CrossRefGoogle ScholarPubMed
Mazeh, D.Bodner, E.Weizman, R.Delayahu, Y.Cholostoy, A.Martin, T., et al.Co-morbid social phobia in schizophrenia. Int J Soc Psychiatry 5532009; 198-202CrossRefGoogle Scholar
Michail, M.Birchwood, M.Social anxiety disorder in first-episode psychosis: incidence, phenomenology and relationship with paranoia. Br J Psychiatry 19532009; 234-241CrossRefGoogle ScholarPubMed
Noyes, R. Jr.Moroz, G.Davidson, J.R.Liebowitz, M.R.Davidson, A.Siegel, J., et al.Moclobemide in social phobia: a controlled dose-response trial. J Clin Psychopharmacol 1741997; 247-254CrossRefGoogle ScholarPubMed
Oakman, J.Van, A.M.Mancini, C.Farvolden, P.A confirmatory factor analysis of a self-report version of the Liebowitz Social Anxiety Scale. J Clin Psychol 5912003; 149-161CrossRefGoogle ScholarPubMed
Pallanti, S.Quercioli, L.Pazzagli, A.Social anxiety and premorbid personality disorders in paranoid schizophrenic patients treated with clozapine. CNS Spectr 592000; 29-43CrossRefGoogle ScholarPubMed
Pallanti, S.Quercioli, L.Hollander, E.Social anxiety in outpatients with schizophrenia: a relevant cause of disability. Am J Psychiatry 16112004; 53-58CrossRefGoogle ScholarPubMed
Rosenberg, M.Society and the adolescent self-image. Princeton, NJ: Princeton University Press: 1965CrossRefGoogle Scholar
Rytwinski, N.K.Fresco, D.M.Heimberg, R.G.Coles, M.E.Liebowitz, M.R.Cissell, S., et al.Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depress Anxiety 2612009; 34-38CrossRefGoogle ScholarPubMed
Safren, S.A.Heimberg, R.G.Horner, K.J.Juster, H.R.Schneier, F.R.Liebowitz, M.R.Factor structure of social fears: The Liebowitz Social Anxiety Scale. J Anxiety Disord 1331999; 253-270CrossRefGoogle ScholarPubMed
Seedat, S.Fritelli, V.Oosthuizen, P.Emsley, R.A.Stein, D.J.Measuring anxiety in patients with schizophrenia. J Nerv Ment Dis 19542007; 320-324CrossRefGoogle ScholarPubMed
Stein, M.B.Chavira, D.A.Subtypes of social phobia and comorbidity with depression and other anxiety disorders. J Affect Disord 50Suppl. 11998; S11-S16CrossRefGoogle ScholarPubMed
Stern, R.G.Petti, T.A.Bopp, K.Tobia, A.Aripiprazole for the treatment of schizophrenia with co-occurring social anxiety: an open-label cross-taper study. J Clin Psychopharmacol 2932009; 206-209CrossRefGoogle ScholarPubMed
Voges, M.Addington, J.The association between social anxiety and social functioning in first episode psychosis. Schizophr Res 762–32005; 287-292CrossRefGoogle ScholarPubMed
Wittchen, H.U.Fehm, L.Epidemiology, patterns of comorbidity, and associated disabilities of social phobia. Psychiatr Clin North Am 2442001; 617-641CrossRefGoogle ScholarPubMed
Wittchen, H.U.Fuetsch, M.Sonntag, H.Muller, N.Liebowitz, M.Disability and quality of life in pure and comorbid social phobia. Findings from a controlled study. Eur Psychiatry 1512000; 46-58CrossRefGoogle ScholarPubMed
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