Abstract
Background
Anxiety disorders are among the most common mental health problems in youth, and faulty interpretation bias has been positively linked to anxiety severity, even within anxiety-disordered youth. Quick, reliable assessment of interpretation bias may be useful in identifying youth with certain types of anxiety or assessing changes on cognitive bias during intervention.
Objective
This study examined the factor structure, reliability, and validity of the Self-report of Ambiguous Social Situations for Youth (SASSY) scale, a self-report measure developed to assess interpretation bias in youth.
Methods
Participants (N = 488, age 7–17) met diagnostic criteria for social phobia, generalized anxiety disorder, and/or separation anxiety disorder. An exploratory factor analysis was performed on baseline data from youth participating in a large randomized clinical trial.
Results
Exploratory factor analysis yielded two factors (accusation/blame, social rejection). The SASSY full scale and social rejection factor demonstrated adequate internal consistency, convergent validity with social anxiety, and discriminant validity as evidenced by non-significant correlations with measures of non-social anxiety. Further, the SASSY social rejection factor accurately distinguished children and adolescents with social phobia from those with other anxiety disorders, supporting its criterion validity, and revealed sensitivity to changes with treatment. Given the relevance to youth with social phobia, pre- and post-intervention data were examined for youth social phobia to test sensitivity to treatment effects; results suggested that SASSY scores reduced for treatment responders.
Conclusions
Findings suggest the potential utility of the SASSY social rejection factor as a quick, reliable, and efficient way of assessing interpretation bias in anxious youth, particularly as related to social concerns, in research and clinical settings.
ClinicalTrials.gov Number NCT00052078.
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Change history
25 July 2018
The original version of this article unfortunately contains the following errors. This has been corrected with this erratum.
Notes
To reduce subjectivity of the factor names, we showed the two groups of items to five child psychologists and psychiatrists and asked them what they would name each factor. For Factor 1 (Accusation/Blame), we got responses such as “Fear of punishment” or “Negative Attributions” or “Blame.” All of these responses are consistent with our naming. Similarly, for Factor 2 (Social Rejection), each expert stated either “social rejection” or “peer rejection.”
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Acknowledgements
This research was supported by funding by the National Institute of Mental Health (U01MH064089 to Dr. Walkup; U01MH64092 to Dr. Albano; U01MH64003 to Dr. Birmaher; U01MH63747 to Dr. Kendall, U01MH64088 to Dr. Piacentini; U01MH064003 to Dr. Compton, T32MH073517 to support Dr. Gonzalez, and T32MH017140 to support Dr. Rozenman) from the National Institute of Mental Health. Views expressed within this article represent those of the authors and are not intended to represent the position of NIMH, NIH, or DHHS.
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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and it later amendments or comparable ethical standards.
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Appendix: SASSY Items
Appendix: SASSY Items
1. | You notice at school one day that a favorite book of yours is missing. Later you notice a boy/girl in your class has a similar book in their bag. What do you think is most likely to have happened to your book? | |
That child has stolen the book and put it in their bag | _____ | |
Someone who doesn’t like you has taken your book so you will be in trouble with your parents | _____ | |
You left your book at home | _____ | |
A friend borrowed the book thinking you wouldn’t mind | _____ | |
2. | You see the School Principal walking around the playground and s/he has been asking other children where you are. Why do you think the Principal is most likely looking for you? | |
The principal has a message for you | _____ | |
The principal thinks you have done something wrong and is angry | _____ | |
The principal wants to tell you he/she has noticed you are working harder and is pleased | _____ | |
One of the other children has told the teachers something bad about you | _____ | |
3. | You arrange to have a party at 4:00 pm and by 4:30 pm no one has arrived. What do you think is most likely to have happened? | |
Your friends are angry at you and don’t want to come | _____ | |
You must have put 4:30 pm on the invitation | _____ | |
Your friends are late because the traffic is very heavy | _____ | |
Your friends don’t want to come because they think it will be really boring | _____ | |
4. | You are showing your school project in front of the class and two students in the back are giggling. What is the reason that they are giggling? | |
They think the project is really dumb | _____ | |
They are being silly and tickling each other | _____ | |
Another kid is making funny faces at them | _____ | |
There is a big stain on your uniform and they are laughing at you | _____ | |
5. | You are sleeping over at a friend’s place and his/her parents seem to be really annoyed and cranky all the time. What is the most likely reason that your friend’s parents are annoyed and cranky all the time? | |
They had a little argument and are a bit upset with each other | _____ | |
They don’t really like you | _____ | |
They think you have done something wrong | _____ | |
They had a party last night and they are tired and don’t feel well | _____ | |
6. | You see a group of students from another class playing a great game. You walk over and want to join in and you hear them laughing. Which of the following do you think is most likely to happen next? | |
They are going to start looking at you and telling secrets about you | _____ | |
They will soon ask you to join in | _____ | |
One of them is likely to rush up and push you away | _____ | |
They are going to notice you and smile | _____ | |
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Gonzalez, A., Rozenman, M., Langley, A.K. et al. Social Interpretation Bias in Children and Adolescents with Anxiety Disorders: Psychometric Examination of the Self-report of Ambiguous Social Situations for Youth (SASSY) Scale. Child Youth Care Forum 46, 395–412 (2017). https://doi.org/10.1007/s10566-016-9381-y
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DOI: https://doi.org/10.1007/s10566-016-9381-y