Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-11T02:52:21.267Z Has data issue: false hasContentIssue false
  • English
  • Français

Latent structure of social fears and social anxiety disorders

Published online by Cambridge University Press:  12 March 2013

M. Iza ,
M. M. Wall ,
R. G. Heimberg ,
T. L. Rodebaugh ,
F. R. Schneier ,
S.-M. Liu  and
C. Blanco
M. Iza*
Affiliation:
New York State Psychiatric Institute, Columbia University, New York, NY, USA
M. M. Wall
Affiliation:
New York State Psychiatric Institute, Columbia University, New York, NY, USA
R. G. Heimberg
Affiliation:
Temple University, Department of Psychology, Philadelphia, PA, USA
T. L. Rodebaugh
Affiliation:
Department of Psychology, Washington University Campus, St Louis, MO, USA
F. R. Schneier
Affiliation:
New York State Psychiatric Institute, Columbia University, New York, NY, USA
S.-M. Liu
Affiliation:
New York State Psychiatric Institute, Columbia University, New York, NY, USA
C. Blanco
Affiliation:
New York State Psychiatric Institute, Columbia University, New York, NY, USA
*
*Address for correspondence: M. Iza, M.D., Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA. (Email: mirenizacia@yahoo.es)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Despite its high prevalence and associated levels of impairment, the latent structure of social anxiety disorder (SAD) is not well understood, with published studies reporting inconsistent results. Furthermore, it is unknown whether the latent structure of social fears in individuals with and without SAD is the same.

Method

Exploratory factor analysis (EFA) and confirmatory factor analysis followed by multiple indicators multiple causes (MIMIC) analysis were conducted on 13 commonly feared social situations assessed in a nationally representative sample including individuals with SAD and those with social fears but who did not meet DSM-IV criteria for SAD.

Results

An EFA conducted in the full sample, including individuals with no social fears (88% of the sample), yielded only one factor. When the sample was restricted to those with at least one social fear, the EFA yielded three factors, in both the subsample with at least one social fear but no SAD and the subsample with SAD. The three factors represented feared situations related to public performance, close scrutiny and social interaction. The MIMIC analyses further indicated that the three-factor structure was able to explain differences in prevalence of social fears across a broad range of sociodemographic covariates.

Conclusions

Among individuals with at least one social fear and those with DSM-IV SAD the latent structure of social fears appears to be best described by three factors, although this may partially depend on how the sample is specified. These results may help reconcile the findings of different numbers of factors identified in previous studies.

Keywords

Latent structureMIMICsocial anxiety disordersocial fears
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 2 , January 2014 , pp. 361 - 370
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychological Association: Washington, DC.Google Scholar
Asparouhov, T, Muthén, B (2006). Robust chi square difference testing with mean and variance adjusted test statistics. Mplus Web Notes no. 10. (http://www.statmodel.com/download/webnotes/webnote10.pdf).Google Scholar
Asparouhov, T, Muthén, B (2009). Exploratory structural equation modeling. Structural Equation Modeling 16, 397–438.CrossRefGoogle Scholar
Bandelow, B, Stein, D (2004). Social Anxiety Disorder. Marcel Dekker: New York.Google Scholar
Blanco, C, Xu, Y, Schneier, FR, Okuda, M, Liu, SM, Heimberg, RG (2011). Predictors of persistence of social anxiety disorder: a national study. Journal of Psychiatric Research 45, 1557–1563.Google Scholar
Chobanian, AV, Bakris, GL, Black, HR, Cushman, WC, Green, LA, Izzo, JL Jr, Jones, DW, Materson, BJ, Oparil, S, Wright, JT Jr, Roccella, EJ (2003). Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 42, 1206–1252.Google Scholar
Cox, BJ, Clara, IP, Sareen, J, Stein, MB (2008). The structure of feared social situations among individuals with a lifetime diagnosis of social anxiety disorder in two independent nationally representative mental health surveys. Behaviour Research and Therapy 46, 477–486.Google Scholar
Dolan, C, Ooort, F, Stoel, R, Wicherts, J (2009). Measurement invariance in the target rotated multiple group exploratory factor analysis. Structural Equation Modeling 16, 295–314.Google Scholar
Fink, M, Akimova, E, Spindelegger, C, Hahn, A, Lanzenberger, R, Kasper, S (2009). Social anxiety disorder: epidemiology, biology and treatment. Psychiatrica Danubina 21, 533–542.Google Scholar
Gelernter, J, Page, GP, Stein, MB, Woods, SW (2004). Genome-wide linkage scan for loci predisposing to social phobia: evidence for a chromosome 16 risk locus. American Journal of Psychiatry 161, 59–66.CrossRefGoogle ScholarPubMed
Grant, BF, Dawson, DA, Stinson, FS, Chou, PS, Kay, W, Pickering, R (2003). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug and Alcohol Dependence 71, 7–16.CrossRefGoogle Scholar
Grant, BF, Hasin, DS, Blanco, C, Stinson, FS, Chou, SP, Goldstein, RB, Dawson, DA, Smith, S, Saha, TD, Huang, B (2005). The epidemiology of social anxiety disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 66, 1351–1361.Google Scholar
Hart, TA, Turk, CL, Heimberg, RG, Liebowitz, MR (1999). Relation of marital status to social phobia severity. Depression and Anxiety 10, 28–32.Google Scholar
Hong, JJ, Woody, SR (2007). Cultural mediators of self-reported social anxiety. Behaviour Research and Therapy 45, 1779–1789.Google Scholar
Hsu, L, Woody, SR, Lee, HJ, Peng, Y, Zhou, X, Ryder, AG (2012). Social anxiety among East Asians in North America: East Asian socialization or the challenge of acculturation? Culturural Diversity and Ethnic Minority Psychology 18, 181–191.CrossRefGoogle ScholarPubMed
Hu, LT, Bentler, PM, Kano, Y (1992). Can test statistics in covariance structure analysis be trusted? Psychological Bulletin 112, 351–362.Google Scholar
Kessler, RC, Chiu, WT, Demler, O, Merikangas, KR, Walters, EE (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617–627.Google Scholar
Kessler, RC, McGonagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, S, Wittchen, HU, Kendler, KS (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Co-morbidity Survey. Archives of General Psychiatry 51, 8–19.Google Scholar
Kim, ES, Yoon, M, Lee, T (2011). Testing measurement invariance using MIMIC: likelihood ratio test with a critical value adjustment. Educational and Psychological Measurement. Published online 06 12 2011 . doi:10.1177/0013164411427395.Google Scholar
Kirmayer, LJ (1991). The place of culture in psychiatric nosology: Taijin kyofusho and DSM-III-R. Journal of Nervous and Mental Disease 179, 19–28.Google Scholar
Lauer, MS, Fontanarosa, PB (2001). Updated guidelines for cholesterol management. JAMA 285, 2508–2509.Google Scholar
Lepine, JP, Lellouch, J (1995). Classification and epidemiology of social phobia. European Archives of Psychiatry and Clinical Neuroscience 244, 290–296.CrossRefGoogle ScholarPubMed
Magee, WJ, Eaton, WW, Wittchen, HU, McGonagle, KA, Kessler, RC (1996). Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Archives of General Psychiatry 53, 159–168.Google Scholar
Marsh, HW, Muthén, B, Asparohov, T, Lüdtke, O, Robitzsch, A, Morin, AJS, Trautwein, U (2009). Exploratory structural equation modeling, integrating CFA and EFA: application to students' evaluations of university teaching. Structural Equation Modeling 16, 439–476.CrossRefGoogle Scholar
Milak, MS, Parsey, RV, Keilp, J, Oquendo, MA, Malone, KM, Mann, JJ (2005). Neuroanatomic correlates of psychopathologic components of major depressive disorder. Archives of General Psychiatry 62, 397–408.Google Scholar
Moitra, E, Beard, C, Weisberg, RB, Keller, MB (2011). Occupational impairment and social anxiety disorder in a sample of primary care patients. Journal of Affective Disorders 130, 209–212.Google Scholar
Muthén, LK, Muthén, BO (1998–2006). Mplus User's Guide. Muthén and Muthén: Los Angeles.Google Scholar
Oakman, J, Van Ameringen, M, Mancini, C, Farvolden, P (2003). A confirmatory factor analysis of a self-report version of the Liebowitz Social Anxiety Scale. Journal of Clinical Psychology 59, 149–161.Google Scholar
Perugi, G, Nassini, S, Maremmani, I, Madaro, D, Toni, C, Simonini, E, Akiskal, HS (2001). Putative clinical subtypes of social phobia: a factor-analytical study. Acta Psychiatrica Scandinavica 104, 280–288.Google Scholar
Polo, AJ, Alegria, M, Chen, CN, Blanco, C (2011). The prevalence and co-morbidity of social anxiety disorder among United States Latinos: a retrospective analysis of data from 2 national surveys. Journal of Clinical Psychiatry 72, 1096–1105.Google Scholar
Ruscio, AM (2010). The latent structure of social anxiety disorder: consequences of shifting to a dimensional diagnosis. Journal of Abnormal Psychology 119, 662–671.Google Scholar
Ruscio, AM, Brown, TA, Chiu, WT, Sareen, J, Stein, MB, Kessler, RC (2008). Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychological Medicine 38, 15–28.CrossRefGoogle ScholarPubMed
Safren, SA, Heimberg, RG, Horner, KJ, Juster, HR, Schneier, FR, Liebowitz, MR (1999). Factor structure of social fears: The Liebowitz Social Anxiety Scale. Journal of Anxiety Disorders 13, 253–270.Google Scholar
Safren, SA, Turk, CL, Heimberg, RG (1998). Factor structure of the Social Interaction Anxiety Scale and the Social Phobia Scale. Behaviour Research and Therapy 36, 443–453.Google Scholar
Sakurai, A, Nagata, T, Harai, H, Yamada, H, Mohri, I, Nakano, Y, Noda, Y, Ogawa, S, Lee, K, Furukawa, TA (2005). Is “relationship fear” unique to Japan? Symptom factors and patient clusters of social anxiety disorder among the Japanese clinical population. Journal of Affective Disorders 87, 131–137.Google Scholar
Stark, S, Chernyshenko, OS, Drasgow, F (2006). Detecting differential item functioning with confirmatory factor analysis and item response theory: toward a unified strategy. Journal of Applied Psychology 91, 1292–1306.Google Scholar
Stein, DJ, Matsunaga, H (2001). Cross-cultural aspects of social anxiety disorder. Psychiatric Clinics of North America 24, 773–782.CrossRefGoogle ScholarPubMed
Stein, MB, Kean, YM (2000). Disability and quality of life in social phobia: epidemiologic findings. American Journal of Psychiatry 157, 1606–1613.CrossRefGoogle ScholarPubMed
Xu, Y, Schneier, F, Heimberg, RG, Princisvalle, K, Liebowitz, MR, Wang, S, Blanco, C (2011). Gender differences in social anxiety disorder: results from the national epidemiologic sample on alcohol and related conditions. Journal of Anxiety Disorders 26, 12–19.CrossRefGoogle ScholarPubMed
Supplementary material: File

Iza et al. supplementary material

Supplementary table

Download Iza et al. supplementary material(File)
File 226.3 KB
Supplementary material: File

Iza et al. supplementary material

Supplementary material

Download Iza et al. supplementary material(File)
File 25.6 KB