A Modified Social Anxiety Scale for Children.

ATLANTA -- The Liebowitz Social Anxiety Scale for Children and Adolescents is the first clinician-rated scale for differentiating anxious children and adolescents from their peers, Eric A. Storch reported in a poster presentation at the annual meeting of the Anxiety Disorders Association of America.

"Research on social phobia in young people has been limited by the absence of reliable and valid clinician rating scales," said Mr. Storch, a doctoral candidate at Columbia University in New York. "Self-report tools fall short because there are some things kids just don't want to divulge."

The Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA) is a scaled-down version of the Liebowitz Social Anxiety Scale (LSAS) with questions tailored for a younger audience. It assesses social interaction and performance situations that children and adolescents with social phobia may fear or avoid. "Instead of asking questions about dating, as in the LSAS, the LSAS-CA focuses on activities in the school setting," Mr. Storch said.

Items on the 24-item scale, which is divided into two subscales that address social and performance situations, were adapted based on reports of the 10 situations most feared by a group of 33 adolescents with social phobia. The LSAS-CA, which differentiates anxious from nonanxious children and adolescents, rates:

* Total fear.

* Fear of social interaction.

* Fear of performance.

* Total avoidance.

* Avoidance of social interaction.

* Avoidance of performance.

As a test of the reliability, validity, and internal consistency of the LSAS-CA, 55 children aged 9-18 years, including 23 with anxiety disorders and 32 normal controls, were assessed using the LSAS-CA and five other standardized, self-reported anxiety scales:

* The Anxiety Disorders Interview Schedule for Children and Parents.

* The Social Phobia and Anxiety Inventory for Children.

* The Social Phobia and Anxiety Inventory

* The Children's Depression Rating Scale.

* The Clinical Global Impression scale.

According to the trial, the LSAS-CA has high internal consistency (Cronbach's alpha = 0.93), high test-retest reliability (total score, r = 0.92; subscores, r = 0.82-0.90), and moderate to high correlations with other scales of anxiety and distress.

Mr. Storch noted that LSAS-CA subscales will be useful for creating different treatment packages and assessing the effectiveness of treatment. "This scale fills a major shortcoming in the literature on social phobia in children and adolescents."