A Psychometric Analysis of the Social Anxiety Scale for Adolescents Among Youth With Autism Spectrum Disorder: Caregiver–Adolescent Agreement, Factor Structure, and Validity

Abstract

Social anxiety is common among adolescents with autism spectrum disorder (ASD). An ongoing challenge for both research and clinical practice in ASD is the assessment of anxious symptomatology. Despite its widespread use in samples of youth with ASD, the Social Anxiety Scale for Adolescents (SAS-A) has not received psychometric evaluation within this population; thus, the validity of its use in research and clinical practice for ASD remains unclear. The present study conducted a psychometric analysis of caregiver and adolescent SAS-A forms in a sample of adolescents with ASD (N = 197). Results revealed (1) poor caregiver–adolescent item-level agreement, (2) a two-factor structure, (3) lack of measurement invariance between reporters, and (4) modest evidence for convergent and discriminant validity. Overall, findings suggest that this measure demonstrates reasonable psychometric properties in an ASD sample. Lack of measurement invariance, however, calls for careful interpretation of research involving the SAS-A in ASD samples, particularly when the primary goal is to compare adolescent and caregiver reports. The implications of these findings for future research and clinical practice are discussed.

I Have a Fear of Negative Evaluation, Get Me Out of Here! Examining Latent Constructs of Social Anxiety and Autistic Traits in Neurotypical and Autistic Young People

“…Items from both the WEMWBS and SDQ were also distinct to those items reporting on FNE, thus further highlighting how FNE might be a key underlying or maintaining factor that can increase an individual's vulnerability specifically to social anxiety. Evidence supporting construct invariance of FNE as measured by SAS-A is also concordant with one recent study that examined psychometric properties of the SAS-A when completed by autistic youths and their caregivers (Schiltz et al 2019). Compared to items that loaded onto the SAD factor which described both generalised social anxiety and anxiety in new social situations, the magnitude of the FNE subscale's factor loadings showed greater consistency between autistic young people and their caregivers.…”

The neurobiological presentation of anxiety in autism spectrum disorder: A systematic review

“…As previously discussed, measurement of anxiety in autism has been found to be complex [Kerns, Rump, et al, ; Mazefsky et al, ; South & Rodgers, ; White et al, ]. Only a handful of measures of anxiety have received comprehensive psychometric evaluation using autism samples [e.g., Magiati et al, ; Schiltz et al, under review; van Steensel, Deutschman, & Bögels, ]. Clinical interviews are generally accepted as more robust than questionnaire measures, yet only one study returned in this review utilized this approach [Hollocks et al, ].…”

“…For symptom severity, it is recommended that measures that have been psychometrically evaluated and found to be reliable and valid in autism samples should be utilized. This includes the Social Anxiety Scale [Schiltz et al, under review] and the Screen for Child Anxiety‐Related Emotional Disorders [van Steensel et al, ]. The Spence Child Anxiety Scale was recently evaluated using a large, international sample and results indicated that it is not an ideal tool for use in autism [Magiati et al, ].…”

Elevated Level of PKMζ Underlies the Excessive Anxiety in an Autism Model

“…Thus, we have provided substantial evidence on the important contribution of PKMζ in BLA to the genesis of anxiety, in both normal mice and ASD model mice. Mounting clinical evidences indicate the prominent presence of anxiety in ASD patients (Ishimoto et al, 2019; Schiltz et al, 2019). We found that reducing PKMζ activity with ZIP peptide reduces anxiety in P35 VPA mice but not in P70 VPA mice.…”