Clinical validation of a non-heteronormative version of the Social Interaction Anxiety Scale (SIAS)

Philip Lindner,Gerhard Andersson,Christopher Martell,Jan Bergström,Per Carlbring

doi:10.1186/1477-7525-11-209

Abstract

IntroductionDespite welcomed changes in societal attitudes and practices towards sexual minorities, instances of heteronormativity can still be found within healthcare and research. The Social Interaction Anxiety Scale (SIAS) is a valid and reliable self-rating scale of social anxiety, which includes one item (number 14) with an explicit heteronormative assumption about the respondent´s sexual orientation. This heteronormative phrasing may confuse, insult or alienate sexual minority respondents. A clinically validated version of the SIAS featuring a non-heteronormative phrasing of item 14 is thus needed.Methods129 participants with diagnosed social anxiety disorder, enrolled in an Internet-based intervention trial, were randomly assigned to responding to the SIAS featuring either the original or a novel non-heteronormative phrasing of item 14, and then answered the other item version. Within-subject, correlation between item versions was calculated and the two scores were statistically compared. The two items’ correlations with the other SIAS items and other psychiatric rating scales were also statistically compared.ResultsItem versions were highly correlated and scores did not differ statistically. The two items’ correlations with other measures did not differ statistically either.ConclusionsThe SIAS can be revised with a non-heteronormative formulation of item 14 with psychometric equivalence on item and scale level. Implications for other psychiatric instruments with heteronormative phrasings are discussed.

Highlights

Despite welcomed changes in societal attitudes and practices towards sexual minorities, instances of heteronormativity can still be found within healthcare and research
The Social Interaction Anxiety Scale (SIAS) can be revised with a non-heteronormative formulation of item 14 with psychometric equivalence on item and scale level
The increased risk of being ostracised and harassed by others has been proposed as an explanation for the finding that sexual minority individuals are at greater risk for developing psychiatric disorders [7,8,9,10]

Summary

Introduction

Despite welcomed changes in societal attitudes and practices towards sexual minorities, instances of heteronormativity can still be found within healthcare and research. The Social Interaction Anxiety Scale (SIAS) is a valid and reliable self-rating scale of social anxiety, which includes one item (number 14) with an explicit heteronormative assumption about the respondents sexual orientation. This heteronormative phrasing may confuse, insult or alienate sexual minority respondents. For individuals who do not equate the trait of attractiveness with the opposite sex, the current phrasing creates a forced arbitrary choice of rating the difficulty of talking to either attractive people, or people of the opposite sex This ambiguity of what is measured may lower the validity of the item and scale when used by sexual minority respondents. A novel, non-heteronormative phrasing of item 14 should reflect this important aspect

Methods

Results

Conclusion