Symptomatic and functional assessment of social anxiety disorder in adults

There are several old and new tools for assessment of generalized SAD but few for nongeneralized SAD. Scales are available in both self-rated and interviewer-rated formats. Self-rated scales vary in appearance in length and specificity for SAD and psychometric properties. The best-studied self-rated scales are the FQ, FNE, SAAD, SPAI, and SPIN. The FQ is an early scale, with a subscale of social phobia with reasonable psychometric properties and has withstood the test of time. The FNE and SAAD are based on cognitive models of SAD but lack assessment of physiologic arousal symptoms--an important symptom cluster of SAD. The SPIN is a relatively new scale and shows potential especially with its three-item screener for generalized SAD. The two interviewer-rated scales, the LSAS and BSPS, are both widely used and demonstrate sound psychometric properties. Either one can be regarded as a satisfactory scale in the assessment of symptom severity and treatment response. The BSPS also measures several physical symptoms common in SAD. There are fewer validated tools available for nongeneralized SAD. It is a prevalent condition that may account for 25% or more of patients with SAD. More research is required on the epidemiology, recognition, assessment, and treatment of nongeneralized SAD. Education of patients and clinicians, and the use of improved and briefer tools in these settings, may help SAD patients to obtain appropriate help and improve their functioning and productivity. Few tools are available that can reliably assess disability due to SAD, and more research in this area is important and required.