Social Phobia and Anxiety Inventory (SPAI)

Purpose and Clinical Application

The Social Phobia and Anxiety Inventory (SPAI) is a comprehensive self-report measure designed to assess social phobia and agoraphobia. Developed by Turner, Beidel, Dancu, and Stanley, it provides detailed assessment of social anxiety symptoms while differentiating between social phobia and agoraphobia.

Clinical Significance

The SPAI is particularly valuable for its ability to distinguish social phobia from other anxiety disorders:

• Differential diagnosis: Distinguishes social phobia from agoraphobia
• Comprehensive assessment: Covers multiple domains of social anxiety
• Treatment planning: Identifies specific areas of impairment
• Progress monitoring: Tracks treatment response
• Research applications: Gold standard for social phobia research

Key Features

• 45 items total: Comprehensive symptom coverage
• Two subscales: Social Phobia (32 items) and Agoraphobia (13 items)
• 7-point Likert scale: 1-7 rating from "never" to "always"
• Difference score: Social Phobia minus Agoraphobia for specificity
• Multiple domains: Cognitive, behavioral, and somatic symptoms

Two-Factor Structure

The SPAI assesses two distinct but related anxiety constructs:

• Social Phobia Subscale (32 items):
  • Fear of negative evaluation in social situations
  • Avoidance of social interactions and performance situations
  • Physical symptoms in social contexts
  • Cognitive symptoms of social anxiety
• Agoraphobia Subscale (13 items):
  • Fear of being in places where escape might be difficult
  • Avoidance of situations due to panic-like symptoms
  • Fear of having panic attacks in public places
  • Dependence on others for support in feared situations

Scoring and Interpretation

Social Phobia Subscale:

• Range: 32-224
• Clinical cutoff: ≥80 suggests social phobia
• Higher scores: Greater social anxiety severity

Agoraphobia Subscale:

• Range: 13-91
• Clinical cutoff: ≥40 suggests agoraphobia
• Higher scores: Greater agoraphobic anxiety

Difference Score (Social Phobia - Agoraphobia):

• Positive scores: Greater social phobia than agoraphobia
• Cutoff ≥18: Specific social phobia diagnosis
• Enhanced specificity: Reduces false positives

Psychometric Properties

• Internal consistency: α = 0.96 (Social Phobia), α = 0.85 (Agoraphobia)
• Test-retest reliability: r = 0.86 (2 weeks), r = 0.74 (10 months)
• Convergent validity: High correlations with other social anxiety measures
• Discriminant validity: Good differentiation from other anxiety disorders
• Sensitivity: 0.84-0.91 for social phobia
• Specificity: 0.85-0.94 for social phobia

Clinical Applications

• Diagnostic assessment: Aids in social phobia diagnosis
• Differential diagnosis: Distinguishes social phobia from agoraphobia
• Treatment planning: Identifies specific symptom targets
• Progress monitoring: Tracks treatment response over time
• Research studies: Comprehensive social anxiety measurement

Social Situations Assessed

The SPAI covers a wide range of social and agoraphobic situations:

• Social Performance: Public speaking, being observed, performing
• Social Interaction: Conversations, meeting new people, assertiveness
• Evaluation Situations: Being criticized, making mistakes, being judged
• Physical Symptoms: Visible anxiety symptoms in social contexts
• Agoraphobic Contexts: Crowded places, transportation, being alone

Advantages and Limitations

Advantages:

• Comprehensive assessment of social anxiety symptoms
• Excellent ability to differentiate social phobia from agoraphobia
• Strong psychometric properties and clinical validity
• Widely used and well-validated across populations
• Provides both severity and diagnostic information

Limitations:

• Relatively long administration time (45 items)
• Some item overlap between subscales
• May be less sensitive to mild social anxiety
• Cultural factors may influence item interpretation

Special Considerations

• Difference score: Use for enhanced diagnostic specificity
• Subscale analysis: Examine both subscales for comprehensive assessment
• Cultural sensitivity: Consider cultural norms in interpretation
• Comorbidity: High rates of comorbidity with depression and other anxiety