Limited Prediction of Performance Validity Using Embedded Validity Scales of the Neurobehavioral Symptom Inventory in an mTBI Veteran Sample.

OBJECTIVE: To test embedded symptom validity scales of the Neurobehavioral Symptom Inventory (NSI) as predictors of performance validity. SETTING: A Veterans Affairs Level II TBI/Polytrauma outpatient care unit in the Midwestern United States. PARTICIPANTS: Veterans with a history of mild traumatic brain injury undergoing neuropsychological assessment as part of their routine care within the TBI/Polytrauma clinic. DESIGN: Retrospective analysis of the existing clinical data. MAIN MEASURES: The NSI, the b Test, Test of Memory Malingering, Reliable Digit Span, California Verbal Learning Test-II Forced Choice. RESULTS: Embedded NSI validity scales were positively correlated with number of performance validity test failures. Participants identified as invalid responders scored higher on embedded NSI validity scales than participants identified as valid responders. Using receiver operating characteristic analysis, the embedded NSI validity scales showed poor sensitivity and specificity for invalid responding using previously published cutoff scores. Only 1 scale differentiated valid from invalid responders better than chance. CONCLUSION: The embedded NSI validity scales' usefulness in predicting invalid neuropsychological performance validity was limited in this sample. Continued measurement of both symptom and performance validity in clinical settings involving traumatic brain injury treatment is recommended, as the present results support the existing research suggesting symptom validity tests and performance validity tests tap into related but ultimately distinct constructs.

The structure of vulnerabilities for social anxiety disorder.

Social anxiety disorder symptoms are generally proposed to be related to broad temperamental vulnerabilities (e.g., a low level of approach and high level of avoidance temperament), specific psychological vulnerabilities (e.g., fears of negative and positive evaluation), and additional disorders (e.g., major depressive disorder). However, existing tests of such a model have either not considered depressive symptoms or relied on samples of undergraduates. We examined these and related questions via a latent variable model in a large dataset (N=2253) that combined participants across a variety of studies. The model had adequate fit in the whole sample, and good fit in a subsample in which more participants completed the depression measure. The model indicated that low level of approach and high level of avoidance temperament contributed to fears of evaluation and social anxiety symptoms, and that fears of evaluation additionally contributed independently to social anxiety symptoms. The relationship between social anxiety and depressive symptoms was entirely accounted for by these vulnerabilities: Depressive symptoms were only predicted by avoidance temperament.

Investigating stereotypes of social anxiety.

BACKGROUND AND OBJECTIVES: This paper consists of two studies that test for the presence and content of stereotypes of highly socially anxious individuals. DESIGN: The current studies examined traits that comprise social anxiety stereotypes, and then tested whether undergraduate students held part of this stereotype via an implicit-association test (IAT). METHODS: In Study 1, a sample of undergraduate students (n = 635) was asked to generate descriptors of people who are highly socially anxious. These descriptors were utilized to create the Social Anxiety Stereotype Measure (SASM) and the underlying factor structure of the SASM was analyzed. In Study 2, a different sample of undergraduate students (n = 87) was given an IAT to further test for the presence of one of the factors obtained in Study 1. RESULTS: Factor analyses indicated the presence of two social anxiety stereotypes: social inhibition and oddity (comparative fit index = .97, Tucker-Lewis Index = .95, root mean square error of approximation = .07, standardized root mean square residual = .06). Oddity as a stereotype of social anxiety was further supported via an IAT: Participants reacted more quickly when oddity (vs. normality) words were paired with social anxiety (vs. social confidence) words (D = -1.15, SD = .26; t(85) = -41.50, p < .001). CONCLUSIONS: Factor analyses revealed two social anxiety stereotypes: social inhibition and oddity. Further testing of the oddity stereotype was supported via an IAT.

Psychometric evaluation of the Concerns of Social Reprisal Scale: Further explicating the roots of fear of positive evaluation.

Fear of positive evaluation (FPE) has been proposed to be an important feature of social anxiety disorder (SAD) and to be rooted, at least partly, in concerns of social reprisal due to positive impressions. In order to formally test this hypothesis, the Concerns of Social Reprisal Scale (CSRS) was developed. The purpose of the present series of studies was to examine the psychometric profile of the CSRS across several independent samples including: a large (n=981) undergraduate sample; a clinical sample of individuals diagnosed with social anxiety disorder (n=27), and a demographically-matched subsample of healthy control participants (n=24). The factorial validity, internal consistency, and construct validity of the CSRS were examined. Results across both studies provided support for the psychometric profile of the CSRS. The implications of concerns of social reprisal for the assessment of social anxiety symptoms, theoretical models of fear of evaluation and SAD, and their potential clinical utility with regard to treating SAD are discussed.

Social anxiety and associations with eating psychopathology: Mediating effects of fears of evaluation.

Recent work suggests unique relations among features of social anxiety disorder and eating disorder pathology. Thus, it may be important to determine specific facets of social anxiety that account for the relation between it and eating disorders. Given the similarities in social-evaluative concerns in both sets of symptoms, we hypothesized that fears of both positive and negative evaluation would each independently account for the relationship between social anxiety symptoms and eating pathology among college females (N=167). Results were partially supportive of hypotheses. Fear of negative evaluation independently accounted for a significant portion of the relationship between social anxiety and each domain of eating pathology that was tested, which included Drive for Thinness, Body Dissatisfaction, and Bulimic Symptoms. Body mass index appeared to play a moderating role on the relationship between fear of negative evaluation and body dissatisfaction, but not drive for thinness or bulimia symptoms. Clinical implications including diagnostic and treatment considerations will be discussed.

Perception matters for clinical perfectionism and social anxiety.

Despite research documenting a relationship between social anxiety and perfectionism, very little research has examined the relationship between social anxiety and clinical perfectionism, defined as the combination of high personal standards and high maladaptive perfectionistic evaluative concern. In the current studies we examined whether clinical perfectionism predicted social anxiety in a large sample of undergraduates (N=602), in a clinical sample of participants diagnosed with social anxiety disorder (SAD; N=180), and by using a variance decomposition model of self- and informant-report of perfectionism (N=134). Using self-report, we found that an interaction of personal standards and evaluative concern predicted both social interaction anxiety and fear of scrutiny, but not in the theorized direction. Specifically, we found that self-report of low standards and high evaluative concern was associated with the highest levels of social anxiety, suggesting that when individuals with SAD hold low expectations for themselves combined with high concerns about evaluation, social anxiety symptoms may increase. Alternatively, when an informants' perspective was considered, and more consistent with the original theory, we found that the interaction of informant-only report of personal standards and shared-report (between both primary participant and informant) of concern over mistakes was associated with self-reported social anxiety, such that high concern over mistakes and high personal standards predicted the highest levels of social anxiety. Theoretical, clinical, and measurement implications for clinical perfectionism are discussed.

Assessing the Straightforwardly-Worded Brief Fear of Negative Evaluation Scale for Differential Item Functioning Across Gender and Ethnicity.

The Brief Fear of Negative Evaluation Scale (BFNE; Leary Personality and Social Psychology Bulletin, 9, 371-375, 1983) assesses fear and worry about receiving negative evaluation from others. Rodebaugh et al. Psychological Assessment, 16, 169-181, (2004) found that the BFNE is composed of a reverse-worded factor (BFNE-R) and straightforwardly-worded factor (BFNE-S). Further, they found the BFNE-S to have better psychometric properties and provide more information than the BFNE-R. Currently there is a lack of research regarding the measurement invariance of the BFNE-S across gender and ethnicity with respect to item thresholds. The present study uses item response theory (IRT) to test the BFNE-S for differential item functioning (DIF) related to gender and ethnicity (White, Asian, and Black). Six data sets consisting of clinical, community, and undergraduate participants were utilized (N=2,109). The factor structure of the BFNE-S was confirmed using categorical confirmatory factor analysis, IRT model assumptions were tested, and the BFNE-S was evaluated for DIF. Item nine demonstrated significant non-uniform DIF between White and Black participants. No other items showed significant uniform or non-uniform DIF across gender or ethnicity. Results suggest the BFNE-S can be used reliably with men and women and Asian and White participants. More research is needed to understand the implications of using the BFNE-S with Black participants.

Psychometric properties of the gaze anxiety rating scale: convergent, discriminant, and factorial validity.

Fear and avoidance of gaze are two features thought to be associated with problematic social anxiety. Avoidance of eye contact has been linked with such undesirable traits as deceptiveness, insincerity, and lower self-esteem. The Gaze Anxiety Rating Scale (GARS) is a self-report measure designed to assess gaze anxiety and avoidance, but its psychometric properties have only been assessed in one preliminary study. We further investigated psychometric properties of the GARS by assessing convergent and factorial validity. We obtained a two-factor solution: gaze anxiety and avoidance across situations (1) in general (GARS-General) and (2) related to dominance communication (GARS-Dominance). The GARS-General factor related more strongly to social anxiety than the GARS-Dominance, and convergent validity of the factors was supported by expected relationships with personality and social anxiety variables. Our results indicate that the GARS subscales are psychometrically valid measures of gaze aversion, supporting their use in future study of the relationship between social anxiety and eye contact behavior.

Validation of the Social Exercise and Anxiety Measure (SEAM): Assessing fears, avoidance, and importance of social exercise.

In two studies (N = 416; N = 118) examining responses from undergraduates, we developed the Social Exercise and Anxiety Measure (SEAM) and tested its factorial, convergent, and divergent validity. Our results demonstrate that the SEAM exhibits an excellent three factor structure consisting of the following subscales: Social Exercise Self-efficacy, Gym Avoidance, and Exercise Importance. In both studies, Social Exercise Self-efficacy correlated negatively and Gym Avoidance correlated positively with social interaction anxiety, fear of scrutiny, and fear of negative evaluation. Exercise Importance correlated positively with frequency of exercise and frequency of public exercise. Implications for the mental and physical health of individuals with high levels of social anxiety are discussed.

Social appearance anxiety, perfectionism, and fear of negative evaluation: distinct or shared risk factors for social anxiety and eating disorders?

Social anxiety and eating disorders are highly comorbid. Social appearance anxiety (i.e., fear of negative evaluation of one's appearance), general fear of negative evaluation, and perfectionism have each been proposed as risk factors for both social anxiety disorder and the eating disorders. However, no research to date has examined all three factors simultaneously. Using structural equation modeling in two diverse samples (N=236; N=136) we tested a model in which each of these risk factors were uniquely associated with social anxiety and eating disorder symptoms. We found support for social appearance anxiety as a shared risk factor between social anxiety and eating disorder symptoms, whereas fear of negative evaluation was a risk factor only for social anxiety symptoms. Despite significant zero-order relationships, two facets of perfectionism (high standards and maladaptive perfectionism) did not emerge as a risk factor for either disorder when all constructs were considered. These results were maintained when gender, body mass index, trait negative affect, and depression were included in the model. It is possible that treating negative appearance evaluation fears may reduce both eating disorder and social anxiety symptoms.

Exploring the Relationship Between Social Anxiety and Bulimic Symptoms: Mediational Effects of Perfectionism Among Females.

Previous findings indicate that social anxiety and bulimia co-occur at high rates; one mechanism that has been proposed to link these symptom clusters is perfectionism. We tested meditational models among 167 female undergraduates in which maladaptive evaluative perfectionism concerns (MEPC; i.e., critical self-evaluative perfectionism) mediated the relationship between social anxiety and bulimic symptoms. Results from a first model indicated that MEPC mediated the relationship between fear of public scrutiny and bulimia symptoms. This indirect effect was significant above and beyond the indirect effects of maladaptive body-image cognitions and perfectionism specific to pure personal standards. A second model was tested with MEPC mediating the relationship between social interaction anxiety and bulimia symptoms. Similar results were obtained; however, in this model, a significant direct effect remained after partialing out the indirect effect of the mediators. Theoretical implications are discussed.