Arabic translation and validation of the Clinician Administered Staden Schizophrenia Anxiety Rating Scale (S-SARS) (preprint)

ABSTRACT

Background: Literature on anxiety in patients with schizophrenia of Arab origin is surprisingly scarce, particularly given that expressions of both psychotic disorders and anxiety disorders can be largely shaped by cultural factors. The present study proposes to complement the literature by examining the psychometric properties of an Arabic translation of the Staden Schizophrenia Anxiety Rating Scale (S-SARS) in a sample of chronic, remitted patients with schizophrenia from Lebanon. As the Arabic version of the Generalized Anxiety Disorder 7‑Item Scale (GAD‑7) has not been previously validated in an Arabic-speaking clinical population of patients with schizophrenia, this study had as a secondary objective to examine the psychometric properties of this scale before its use. Method: his cross-sectional study has been conducted during August and October 2023. A total of 117 chronic inpatients diagnosed with schizophrenia who were remitted and clinically stable filled the survey, with a mean age of 57.86 ± 10.88 years and 63.3% males. Results: Confirmatory factor analyses showed that all 10 items were condensed into a single factor and had high factor loading values between 0.53 and 0.81. The reliability of the Arabic version of the S-SARS was excellent as attested by a Cronbach’s alpha and a McDonald’s omega coefficients of 0.89 and .90, respectively. The score of Arabic S-SARS correlated positively with the GAD-7 scores (r = .55; p < .001), thus supporting good convergent validity. As for discriminant validity, findings showed positive correlations between S-SARS and depression scores as assessed using the Calgary Depressive Symptoms Scale. In addition, the Arabic S-SARS correlated negatively with general functioning, further supporting the good validity and clinical relevance of the scale. Finally, measurement invariance was established in the gender subsamples (males vs. females) at the configural, metric and scalar levels, with females showing more anxiety than males. Conclusion: Findings suggest that the Arabic S-SARS holds good psychometric properties, and is suitable for use among Arabic-speaking patients with schizophrenia in clinical practice and research. The Arabic version of S-SARS will hopefully be widely applied to provide useful and timely clinical information for monitoring and adequately treating patients with schizophrenia, in order to improve the course and prognosis of the disease.