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Assessing differential item functioning for the Social Appearance Anxiety Scale: a Scleroderma atient-centred
Sophia J Sommer1,2, Daphna Harel1,2, Linda Kwakkenbos3
1Applied Statistics, Social Science and Humanities, New York University, New York, New York, USA.
BMJ Open
|October 13, 2020
Summary
The Social Appearance Anxiety Scale (SAAS) and its shortened version (SAAS-5) show comparable scores across different languages, sexes, and disease types. This confirms the scale
Area of Science:
- Psychometrics
- Health Psychology
- Scleroderma Research
Background:
- The Social Appearance Anxiety Scale (SAAS) measures fear of appearance-based evaluation.
- Understanding score comparability across diverse patient groups is crucial for accurate assessment.
- Investigating differential item functioning (DIF) helps ensure measurement invariance.
Purpose of the Study:
- To investigate differential item functioning (DIF) in the 16-item SAAS comparing English and French versions.
- To examine DIF based on sex and disease status for the SAAS.
- To assess DIF for the SAAS-5 across language, sex, and disease status.
Main Methods:
- Cross-sectional analysis of baseline data from the Scleroderma Patient-centred Intervention Network (SPIN) cohort.
- Statistical analysis of DIF for the SAAS and SAAS-5 using data from 1640 patients.
- Comparison of factor scores before and after accounting for DIF.
Main Results:
- Statistically significant language-based DIF was found in six SAAS items.
- Four SAAS items showed sex-based DIF, and one showed disease type-based DIF.
- Factor scores remained highly similar (Pearson correlation >0.99) after DIF adjustment for both SAAS versions.
Conclusions:
- SAAS and SAAS-5 scores demonstrate comparability across language, sex, and disease type.
- Minor item-level response differences do not significantly impact overall score interpretation.
- The SAAS is a reliable measure for diverse patient populations in appearance anxiety research.
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