Turner, the SPAI. Another area of limitation

 

Turner, S. M., et
al. (1989). An empirically derived inventory to measure social fear and
anxiety: The Social Phobia and Anxiety Inventory. Psychological Assessment: A Journal of Consulting and Clinical
Psychology, 1(1), 35-40.

SPAITM. (n.d.). Retrieved December 13, 2017,
from https://www.mhs.com/MHS-Assessment?prodname=spai

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Gillis, M. M., et
al. (1995). Normative values for the Beck Anxiety Inventory, Fear
Questionnaire, Penn State Worry Questionnaire, and Social Phobia and Anxiety
Inventory. The American University, 7(4),
450-455.

Clark, Duncan B., et al. (1994). Reliability and
validity of the Social Phobia and Anxiety Inventory for adolescents. APA PsychNET Direct, 6(5), 135-140.

Beidel, D. C., et al. (1995). A new inventory to
assess childhood social anxiety and phobia: The Social Phobia and Anxiety
Inventory for Children. Psychological
Assessment, 7(1), 73-79.

References

 

To eliminate bias in future research, it would be wise to
incorporate online testing of the SPAI since many individuals suffering from
Social Phobia and Agoraphobia are housebound, or at the very least, find it
difficult to seek help. The likelihood of obtaining enough data to adequately
produce accurate information about the construct group is skewed when testing
sites are oppositional to these disorders’ symptoms. Therefore, future research
should revolve around investigating further validity of the SPAI.

Another area of limitation involves the location of where
sampling was conducted. For example, only one major area in the Northeast U.S.
was administered the SPAI (a location where the prevalence of anxiety disorders
is highest in the country) (Gillis, 1995). Also contributing to testing bias is
the location where testing took place. Heavily public areas were used for test,
a likely area that Agoraphobics and Social Phobics would avoid. Likewise, the
screening process prior to testing can be considered a likely anxiety-provoking
situation for Social Phobics.

It appears that the strengths of the SPAI include an
adequate sample size and a close match to U.S. demographic variables. Likewise,
therapists can be expected to adequately work alongside patients in clinical
settings with support from these findings as being beneficial in understanding
anxiety symptoms in correlation to Social Phobia. However, this assessment also
has some weaknesses. The SPAI was administered to non-English speaking citizens
without sometimes adequate Spanish translations of subscales.

Summary Evaluation and Critique

The SPAI appears to be an effective instrument to use since
it was distributed to 114 psychologists and psychiatrists in the United States
and Canada considered to be experts in social-related anxiety disorders
(Turner, 1989). Researchers further evaluated the SPAI to ensure that it could
accurately differentiate Social Phobics from other anxiety disorder suffers,
and they concluded that the overall accuracy was 67.9% according to the
discriminant function (Turner, 1989). This percentage indicates that more than
half of the patients identified as having Social Phobia were appropriately
classified. This rate exceeds the percentage that would have been calculated by
using the base rate alone (i.e., 24%). Likewise, researchers also
differentiated Agoraphobics accurately from Social Phobics (75.6%), and again
this is substantially higher than the base rate (52%). Those individuals
purporting Obsessive-Compulsive Disorder symptoms were correctly identified as
well (38.9%) compared to the base rate (21%).

The final version of the SPAI used for research included a
total of 32-items, 11 which related to feelings of anxiety and specific anxiety
producing situations, and required patients to rate distress. Two questions require
individuals to purport specific thoughts prior to social situations (i.e.,
anticipatory thoughts). Three items relate to physical symptoms common to
suffers of Social Phobia, and 13-items correlate with Agoraphobia subscale
symptoms (i.e., fear of panic attacks) (Turner, 1989). These evaluations were
based on the Diagnostic and Statistical Manual of Mental Disorders III
(DSM-III), and patients were required to be evaluated based on this standard
prior to testing.

The psychometric properties of the initial SPAI consisted of
a 41-items with 25 multiple response choices available (Turner, 1989). Examples
of questions asked include somatic and psychological symptoms of anxiety in
social situations (e.g., eating in public, addressing authority, communicating
with friends and family, etc.). In total, there are 13 somatic symptoms and 9
specific cognitive symptoms included in the SPAI; thus, resulting in a total of
176 possible combinations of responses (Turner, 1989).  Answers were recorded on a 7-point scale (1 =
never, 2 = very infrequent, 3 = infrequent, 4 = sometimes, 5 = frequent, 6 =
very frequent, and 7 = always).

The SPAI was the first empirically derived assessment used
to distinguish Social Phobia from other anxiety disorders (Turner, 1989). In
order for this test to conclude levels of severity in patients, the instrument
utilizes a Likert-scale format for evaluation.

Practical Evaluation

The confirmatory factor analysis established the validity of
the two separate factors of Social Phobia and Agoraphobia (Clark, 1994). Currently,
the SPAI displays high test – retest reliability (over 2-weeks) and good
internal consistency (Turner, 1989). The reliability estimates by Cronbach
alpha were acceptable for the SPAI subscales (i.e., Social Phobia, Agoraphobia)
and total (Clark, 1994). Also, the assessment demonstrated solid construct
validity. The results indicated a significant relationship with independent
measure of social phobia and other anxiety variables (Clark, 1994).
Accordingly, the SPAI is a reliable and valid measure of Social Phobia (Clark,
1994).

To obtain candidates for analysis, researches asked random
participants to answer questions that would take no longer than 10 minutes
(Gillis, 1995). Participants were first screened to see if they were applicable
for certain age brackets, and then given the assessment to complete if they met
requirements for a diagnosis of Social Phobia. The control group consisted of individuals
presenting without social anxiety symptoms while the other two groups either
had a diagnosis of Social Phobia or met the criteria for diagnosis without ever
being formally identified.

The SPAI has been standardized with a norm group of U.S.
adults ranging from ages 18 to 65 and across four variables: gender, age,
ethnicity, and socioeconomic status (Gillis, 1995). Since the SPAI is designed
for individuals with a 6th grade reading level and 14 years of age
and above, then the assessment can be administered to a wide variety of
individuals in various environmental backgrounds. For example, the SPAI was
given to 49% of men, 51% of women, 84% of Caucasian, 12% of Blacks, 9% of
Hispanics, and 3% of other races (Gillis, 1995).  Likewise, respondents recorded for the SPAI
were from various SES backgrounds ranging from roughly $16,000 – $60,000.

Technical Evaluation

Research provided indicates that a cut off score of 80 would
be sufficient enough to indicate a diagnosis of Social Phobia (Turner, 1989).
However, if a score of 60 or above were indicated as the cut-off mark, then
14.3% of socially anxious people would be identified as having a disorder other
than Social Phobia, thus, indicating a false negative. Subsequently, this lower
cut-off score would have indicated a high percentage of Agoraphobics (60%) and
a moderate level of Obsessive-Compulsives (39.9%) as being incorrectly
identified as meeting criteria for Social Phobia. Therefore, as the cut-off
score increases to 80, the chance for false negatives increases and false
positives decreases substantially (Turner, 1989).

The SPAI contains 45-items that purport on somatic and
cognitive symptoms associated with avoidant or escape behaviors in Social
Phobia (Gillis, 1995). There are three subscales that this assessment test
measures, one for Social Phobia (with scores ranging from 0 to 192), one for Agoraphobia
(with scores ranging from 0 to 78), and a third subscale (which measures the
total difference between the other two subscales).

This assessment instrument is vital for recognizing,
diagnosing, and getting clinical help to adolescents and adults who present
with Social Phobia symptoms. Prior to research, no professionals had made the
distinct observation between anxiety symptoms and specific Social Phobia
behavioral and cognitive distortions. Research suggests that the average age of
onset f or Social Phobia is 12.3 years of age, and children as young as 8 have
been diagnosed (Beidel, 1995). The creation of the SPAI is important for these
individuals suffering so they may receive the help they need to recover form
anxiety.

The SPAI was developed since there had previously been no
useful tools to measure the presence of Social Phobia in children and adults (Beidel,
1995). Despite emerging interest in understanding anxiety disorders in general,
there has been lacking research involved in discovering sound methodological
investigations for Social Phobia; therefore, many questions about the disorder
remain (Beidel, 1995).

Test Description

This assessment test is neither a personality test nor an
intelligence or achievement test; instead, it is a test which measures the
level of psychological disturbance (i.e., anxiety) in individuals. The SPAI is
an objective measure instrument since it scores high on reliability and
validity. Likewise, the SPAI requires test takers to make distinct choices to a
structured set of questions and instructions (e.g., true/false, yes/no, or
correct answer) (Silverman, n.d.). The ideal location for use of the SPAI is in
schools, clinics, treatment facilities, and prisons where patients may be
easily monitored for symptoms (SPAITM, n.d.).

The SPAI consists of 45-items that measure two subscales (e.g.,
Social Phobia and Agoraphobia), and the test can be self-scored by test-takers
by using scoring cards. The assessment is currently available in three
variations (e.g., SPAI Complete Kit/Preview Set, SPAI Forms, and SPAI Manual),
and each test must be hand scored using MHS QuikScore Forms. The results will
ultimately purport whether the patient has a diagnosable mental disorder
congruent with Social Phobia. The cost of purchase for each version of the
assessment ranges from USD $60 – $120 (SPAI Forms/Manuals – SPAI Complete Kit,
respectively), and, currently, there are no online variations of the SPAI
available for professionals to administer.

            The
Social Phobia and Anxiety Inventory (SPAI) was first created in 1989 by Samuel
M. Turner, Ph.D., Deborah C. Beidel, Ph.D., and Constance V. Dancu, Ph.D. to
distinguish psychological symptoms of Social Phobia from other mental health conditions
(e.g., Panic Disorder with Agoraphobia and Obsessive-Compulsive Disorder). The
SPAI was published by the Multi-Health Systems, Inc. (MHS) which has been a
leading publisher of scientifically validated assessments over the past 30
years (SPAITM,
n.d.).

General Information

The Social Phobia and Anxiety Inventory (SPAI) is an
assessment instrument first created in 1989 by professionals to help assess
specific cognitive and behavioral symptoms that measure anxiety and fear of
individuals in social situations.  The
creators of this assessment sought out to bring a distinction to the two
psychological diagnoses: Social Phobia and Panic Disorder with Agoraphobia. This
test is offered in multiple formats that can be administered to various groups
of individuals in different environments, specifically to those who contain at
least a 6th grade reading level.

Test Critique: Social Phobia and
Anxiety Inventory

Keywords:  SPAI, Social Phobia, Agoraphobia, Panic
Disorder

This paper discusses the development, reliability, and unique
ability of a new instrument to asses Social Phobia. The Social Phobia and
Anxiety Inventory (SPAI) is an empirical instrument which incorporates
responses from the cognitive, somatic, and behavioral dimensions of social
fear. This assessment discovers important distinctions between Social Phobia,
Panic Disorder with and without Agoraphobia, and Obsessive-Compulsive Disorder
(to a lesser degree) (Turner, 1995). The SPAI has demonstrated high test-retest
reliability and adequate internal consistency due to the systematic strategy
used to derive final scores (Turner, 1995). This instrument appears to be
representative of all symptoms associated with social anxiety and is capable of
discerning Social Phobia from other anxiety patients (e.g., Agoraphobics) and
normal control group individuals without anxiety symptoms. This paper evaluates
the effectiveness of this instrument in assessing patients for Social Phobia
and anxiety symptoms. It also analyzes the usefulness of the SPAI in treatment
planning for patients with Social Phobia symptoms in clinical settings.

Abstract

Liberty University

Luke K. Swain

Test Critique: Social Phobia and Anxiety
Inventory

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