Assessing Symptom Accommodation of Social Anxiety Symptoms Among Chinese Adults: Factor Structure and Psychometric Properties of Family Accommodation Scale Anxiety—Adult Report

Abstract

Objective: Symptom accommodation is an important interpersonal construct associated with more severe symptoms, lower levels of functioning, and worse treatment outcomes across various mental health conditions, including social anxiety. Research on this phenomenon is surprisingly absent in Chinese culture, where interpersonal relationships are highly emphasized. This may be due to the absence of a valid Chinese symptom accommodation measure for individuals with social anxiety symptoms. The current study aimed to examine the factor structure and psychometric properties of the Family Accommodation Scale Anxiety-Adult Report (FASA-AR) in Chinese adults. Methods: Three hundred and seventy-five Chinese undergraduate students with social anxiety symptoms completed a battery of self-report measures assessing symptom accommodation in relation to social anxiety symptoms and related impairments, as well as overall symptoms of anxiety and depression. Results: Confirmatory factor analysis supported a two-factor model of symptom accommodation, with factors named Participation in symptom-related behaviors and Modification of functioning. The multiple indicators multiple causes model indicated the indicators of the FASA-AR, mainly the participation in symptom-related behaviors subscale, were not invariant across gender. Internal consistency for the FASA-AR total score and subscale scores was good. Convergent validity of the FASA-AR was evidenced by significant positive association with ratings of social anxiety symptoms, social anxiety related impairments, and anxiety symptoms. Divergent validity was supported by non-significant relation with depression symptoms. Nearly all participants (94.7%) endorsed being accommodated to some extent in the past month.

Partner symptom accommodation in generalized anxiety disorder: a preliminary examination of correlates with symptoms and cognitive behavioural therapy outcome

“…In alignment with the present study objectives and consistent with past research (e.g. Lou et al, 2020), the FASA-AR was modified such that references to 'relative' were substituted with 'partner' in the instructions and items.…”

“…Family Accommodation Scale Anxiety -Adult Report (FASA-AR; Lebowitz et al, 2015;Lou et al, 2020) The FASA-AR is a 16-item self-report measure of the extent to which people change their behaviours and routines to decrease disorder-related symptoms in the past month for adults with anxiety. The FASA-AR was adapted based on the Family Accommodation Scale Anxiety -Child Report (FASA-CR), which is a measure of SA reported by the child with an anxiety disorder as opposed to the parent (Lebowitz et al, 2015).…”

“…The first objective of the study was to assess the frequency of SA as assessed by the Family Accommodation Scale Anxiety -Adult Report (FASA-AR; Lebowitz et al, 2013;Lebowitz et al, 2015). The FASA-AR is a measure of SA for anxiety disorders that was adapted from the child report version (Lebowitz et al, 2013) and validated in an adult sample with social anxiety disorder (Lou et al, 2020).…”

“…The Family Accommodation Scale (FAS; Calvocoressi et al, 1995) was the first measure developed to systematically assess SA in obsessivecompulsive disorder (OCD). The FAS is now a widely used measure that has undergone adaptations for other disorders, including anxiety disorders (Lebowitz et al, 2013;Lebowitz et al, 2015;Lou et al, 2020). SA maintains anxiety pathology through avoidance and reinforcement of maladaptive behaviours that, in turn, preclude exposure to anxiety-provoking situations and prevent adaptive coping (Kagan et al, 2017).…”

Context matters: criticism and accommodation by close others associated with treatment attitudes in those with anxiety

“…Accommodation was measured using the Family Accommodation Scale Anxiety-Adult Version (FASA-AR; Lou et al, 2020), which shows good internal consistency and convergent and divergent validity. This scale asks participants to identify the person who is most involved in their anxiety, then answer nine questions about the frequency (0, 'very rarely' to 4, 'very often') of different kinds of accommodation (e.g.…”