Translation and validation of liebowitz social anxiety scale and a randomized controlled trial investigating the effectiveness of group cognitive behavior therapy versus a wait list control of university students with social phobia.

Abstract

Background: Despite being one of the most prevalent psychiatric disorders, social phobia remains to be under-diagnosed. To date no instrument to measure social phobia in available in Sinhalese. Cognitive Behavior Group Therapy (CBGT) has not only been proven effective but also cost-effective in other countries fbr adults with social phobia. Objective: to translate and validate the Liebowitz Social Anxiety Scale- self-rated (LSAS-SR) in to Sinhalese and to determine the effectiveness of CBGT as compared to a waitlist control of university students with social phobia. Method: Translation, adaptation and validation followed the standard procedure. DSM IV was used as the gold standard to diagnose social phobia. A single-blind randomized controlled trial consisting of an 8-week treatment phase with a modified form of CBGT versus a waitlist control was conducted among consenting university students with social phobia. Results: Cut- off of 39 had the best sensitivity and specificity. The Cronbach's alpha between the totals of avoidance and fear subscales was 0.919. The test-retest reliability fbr the fear subscale, avoidance subscale and the total score were 0.998, 0.999 and 0.994 respectively with a correlation significant at 0.01. Repeated measure analysis of the total scores of the Sinhala version of LSAS-SR in CBGT arm showed statistically significant (p<0.001) reduction in the total scores (13.6222) when compared to the scores in the waitlist arm. Conclusions: Cutoff value of 39 fbr the Sinhala translation of the LSAS-SR supports findings of other studies with regard to psychometric properties. CBGT is effective in treating university students with social phobia in Sri Lanka. Larger scale studies among other people with social phobia also looking at cost-effectiveness may provide more light on this.