Cross-ethnic measurement equivalence of measures of depression, social anxiety, and worry.

Although study of clinical phenomena in individuals from different ethnic backgrounds has improved over the years, African American and Asian American individuals continue to be underrepresented in research samples. Without adequate psychometric data about how questionnaires perform in individuals from different ethnic samples, findings from both within and across groups are arguably uninterpretable. Analyses based on item response theory (IRT) allow us to make fine-grained comparisons of the ways individuals from different ethnic groups respond to clinical measures. This study compared response patterns of African American and Asian American undergraduates to White undergraduates on measures of depression, social anxiety, and worry. On the Beck Depression Inventory-II, response patterns for African American participants were roughly equivalent to the response patterns of White participants. On measures of worry and social anxiety, there were substantial differences, suggesting that the use of these measures in African American and Asian American populations may lead to biased conclusions.

Psychometric properties of disability measures among patients with social anxiety disorder.

BACKGROUND: Although recognition of the importance of disability as a construct has increased in recent years, there has been little examination of the reliability and validity of disability measures. METHODS: This study examined three disability measures, the Liebowitz Self-Rated Disability Scale (LSRDS), the clinician-rated Disability Profile (DP), and the Sheehan Disability Scale (SDS) among patients with a primary diagnosis of social anxiety disorder. RESULTS: The disability measures correlated strongly with each other, as well as with measures of social anxiety, depressive symptoms, and patients' subjectively-evaluated quality of life. The LSRDS and DP were more internally consistent than the SDS Total Score. All measures discriminated between patients with generalized and non-generalized social anxiety disorder. However, the LSRDS and DP also showed greater sensitivity to ecological indicators of distress than the SDS. Social anxiety symptoms accounted for significant variance in disability, above and beyond that accounted for by depressive symptoms. CONCLUSIONS: Overall, the LSRDS, DP, and SDS appear to be valid tools in the study of disability in social anxiety disorder, although the LSRDS and the DP appear to be somewhat more sensitive to the experiences of socially anxious patients.

The experience of disability and quality of life in social anxiety disorder.

Although disability is a concept most often associated with role dysfunction, and quality of life is most often associated with life satisfaction, these terms are frequently used interchangeably in the literature. In contrast, this study proposes that disability and quality of life are independent but related constructs. Additionally, we propose that disability partially mediates the relationship between symptoms and quality of life. That is, greater symptoms are associated with more impairment, which is, in turn, associated with less satisfaction with one's life. Ninety-six individuals with social anxiety disorder were given measures of social anxiety symptoms, disability, and quality of life. The results of the study suggest that disability and quality of life are, in fact, distinct concepts, and the experience of disability partially mediates the relationship between a patient's experience of symptoms and his or her perceived life satisfaction.

Cognitive-behavioral therapy for social anxiety disorder: supporting evidence and future directions.

The present paper examines the role of cognitive-behavioral therapy (CBT) in the treatment of social anxiety disorder (SAD). A cognitive-behavioral model of SAD is first presented. Different modalities of CBT for SAD are then described, including exposure, cognitive restructuring, relaxation training, and social skills training, and evidence supporting their efficacy is reviewed. The comparative and combined impact of CBT and pharmacotherapeutic interventions is also explored. CBT appears to be an efficacious treatment for SAD. However, the overall efficacy CBT may be increased by closer examination of the active ingredients of treatment. Such analyses may also enable more successful integration of the different CBT techniques and of CBT and pharmacotherapy in the treatment of SAD.