Ranta Klaus, Kaltiala-Heino Riittakerttu, Rantanen Päivi, Tuomisto Martti T, Marttunen Mauri
Tampere School of Public Health, University of Tampere, Finland; Department of Adolescent Psychiatry, Turku University Hospital, Finland.
Eur Psychiatry. 2007 May;22(4):244-51. doi: 10.1016/j.eurpsy.2006.12.002. Epub 2007 Mar 7.
Social phobia (SP) has onset during early adolescence, and is associated with significant impairment in social and educational functioning of adolescents. Therefore, valid and easy-to-use tools for screening and identification of SP among adolescent community populations are needed. We investigated both construct and discriminative validity, and screening properties of the 17-item Social Phobia Inventory (SPIN) relative to SP diagnoses based on a semi-structured clinical interview (K-SADS-PL), in a sample of 752 12 to 17-year-old Finnish students from general population. The SPIN demonstrated good properties to differentiate adolescents with SP and those with sub-clinical SP symptoms (SSP), from adolescents without SP. The SPIN also differentiated adolescents with SP from those with depressive and disruptive disorders. In this sample 27% of participants scored above the previously suggested SPIN cut-off (15 points) for adolescent SP. We suggest using a somewhat higher cut-off score, 24 points, when using the SPIN as a screen for SP in general adolescent populations. This cut-off score resulted in a sensitivity of 81.2%, a specificity of 85.1%, a positive predictive value of 26.9%, and a negative predictive value of 98.6% in relation to the SP diagnosis in our sample. To screen for both SP and SSP, 19 points as a cut-off score produced satisfactory diagnostic efficiency statistics. The SPIN appears to have good properties for screening and identification of adolescent SP.
社交恐惧症（SP）在青春期早期发病，与青少年的社交和教育功能显著受损有关。因此，需要有效且易于使用的工具来筛查和识别青少年社区人群中的社交恐惧症。我们在752名来自普通人群的12至17岁芬兰学生样本中，研究了17项社交恐惧症量表（SPIN）相对于基于半结构化临床访谈（K-SADS-PL）的社交恐惧症诊断的结构效度、区分效度和筛查特性。SPIN表现出良好的特性，能够将患有社交恐惧症的青少年以及有亚临床社交恐惧症症状（SSP）的青少年与没有社交恐惧症的青少年区分开来。SPIN还能将患有社交恐惧症的青少年与患有抑郁和破坏性行为障碍的青少年区分开来。在这个样本中，27%的参与者得分高于先前建议的青少年社交恐惧症的SPIN临界值（15分）。我们建议在将SPIN用作一般青少年人群社交恐惧症筛查工具时，使用稍高的临界值分数，即24分。相对于我们样本中的社交恐惧症诊断，这个临界值分数的灵敏度为81.2%，特异度为85.1%，阳性预测值为26.9%，阴性预测值为98.6%。为了同时筛查社交恐惧症和亚临床社交恐惧症，以19分为临界值分数产生了令人满意的诊断效率统计数据。SPIN似乎具有良好的特性，可用于筛查和识别青少年社交恐惧症。
