Advertisement

The Social Suspiciousness Scale: Development, Validation, and Implications for Understanding Social Anxiety Disorder

  • Andrea Linett
  • Jennifer Monforton
  • Meagan B. MacKenzie
  • Randi E. McCabe
  • Karen Rowa
  • Martin M. AntonyEmail author
Article

Abstract

The Social Suspiciousness Scale (SSS) is a 24-item self-report questionnaire designed to assess suspiciousness, along with the associated constructs of anger and hostility, within a social context. The present research evaluated the psychometric properties of this newly developed scale. The sample consisted of outpatients with social anxiety disorder (SAD; n = 145), unselected undergraduate university students (n = 162), and healthy community controls (n = 46). A principal components analysis suggested a one-factor solution. Internal consistency of the scale was high, and interitem correlations indicated that items were nonredundant. Test-retest reliability was strong. SSS scores were moderately correlated with measures of social anxiety, paranoia, anger and hostility. Moreover, in the outpatient SAD sample, SSS scores decreased significantly following a 12-week cognitive-behavioral group treatment program for SAD. The SSS may be a useful tool for measuring suspiciousness, anger and hostility across a variety of social contexts, particularly in individuals with SAD. This research contributes more generally to a broader understanding of SAD, and supports the importance of considering the role of mistrust and suspiciousness in this disorder.

Keywords

Social anxiety disorder Social phobia Suspiciousness Mistrust 

Notes

Compliance with Ethical Standards

Conflict of Interest

Andrea Linett, Jennifer Monforton, Meagan B. MacKenzie, Randi E. McCabe, Karen Rowa, and Martin M. Antony declare that they have no conflict of interest.

Experiment Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.

References

  1. Achim, A. M., Maziade, M., Raymond, E., Olivier, D., Merette, C., & Roy, M. A. (2011). How prevalent are anxiety disorders in schizophrenia? A meta-analysis and critical review on a significant association. Schizophrenia Bulletin, 37, 811–821.  https://doi.org/10.1093/schbul/sbp148.CrossRefGoogle Scholar
  2. Adler, L. A., Spencer, T., Faraone, S. V., Kessler, R. C., Howes, M. J., Biederman, J., & Secnik, K. (2006). Validity of pilot adult ADHD self-report scale (ASRS) to rate adult ADHD symptoms. Annals of Clinical Psychiatry, 18, 145–148.  https://doi.org/10.1080/10401230600801077.CrossRefGoogle Scholar
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th ed. In DSM-5. Arlington: American Psychiatric Press.Google Scholar
  4. Antony, M. M., Roth, D., Swinson, R. P., Huta, V., & Devins, G. M. (1998). Illness intrusiveness in individuals with panic disorder, obsessive compulsive disorder, or social phobia. Journal of Nervous and Mental Disease, 186, 311–315.  https://doi.org/10.1097/00005053-199805000-00008.CrossRefGoogle Scholar
  5. Antony, M. M., Coons, M. J., McCabe, R. E., Ashbaugh, A., & Swinson, R. P. (2006). Psychometric properties of the social phobia inventory: Further evaluation. Behaviour Research and Therapy, 44, 1177–1185.  https://doi.org/10.1016/j.brat.2005.08.013.CrossRefGoogle Scholar
  6. Asberg, K. (2013). Hostility/anger as mediator between college students’ emotion regulation abilities and symptoms of depression, social anxiety, and generalized anxiety. Journal of Psychology: Interdisciplinary and Applied, 147, 469–490.  https://doi.org/10.1080/00223980.2012.715601.CrossRefGoogle Scholar
  7. Bendig, A. W. (1962). Factor analytic scales of covert and overt hostility. Journal of Consulting Psychology, 26, 200.  https://doi.org/10.1037/h0048664.CrossRefGoogle Scholar
  8. Breen, W. E., & Kashdan, T. B. (2011). Anger suppression after imagined rejection among individuals with social anxiety. Journal of Anxiety Disorders, 25, 879–887.  https://doi.org/10.1016/j.janxdis.2011.04.009.CrossRefGoogle Scholar
  9. Bryant, F. B., & Smith, B. D. (2001). Refining the architecture of aggression: A measurement model for the Buss-Perry aggression questionnaire. Journal of Research in Personality, 35, 138–167.  https://doi.org/10.1006/jrpe.2000.2302.CrossRefGoogle Scholar
  10. Buss, A. H. (1961). The psychology of aggression. New York: Wiley.CrossRefGoogle Scholar
  11. Buss, A. H., & Perry, M. (1992). The Aggression Questionnaire. Journal of Personality and Social Psychology, 63, 452–459.  https://doi.org/10.1037/0022-3514.63.3.452.CrossRefGoogle Scholar
  12. Butler, R. W. (1996). Positive symptoms of psychosis in posttraumatic stress disorder. Biological Psychiatry, 39, 839–844.  https://doi.org/10.1016/0006-3223(95)00314-2.CrossRefGoogle Scholar
  13. Clark, D. M. (2001). A cognitive perspective on social phobia. In W. R. Crozier & L. E. Alden (Eds.), International handbook of social anxiety: Concepts, research and interventions relating to the self and shyness (pp. 405–430). New York: John Wiley and Sons.Google Scholar
  14. Connor, K. M., Davidson, J. R., Churchill, L. E., Sherwood, A., Foa, E., & Weisler, R. H. (2000). Psychometric properties of the social phobia inventory (SPIN). New self-rating scale. British Journal of Psychiatry, 176, 379–386.  https://doi.org/10.1192/bjp.176.4.379.CrossRefGoogle Scholar
  15. Cooper, S., Klugman, J., Heimberg, R. G., Anglin, D. M., & Ellman, L. M. (2016). Attenuated positive psychotic symptoms and social anxiety: Along a psychotic continuum or different constructs? Psychiatry Research, 235, 139–147.  https://doi.org/10.1111/eip.12439.CrossRefGoogle Scholar
  16. DeWall, C. N., Buckner, J. D., Lambert, N. M., Cohen, A. S., & Fincham, F. D. (2010). Bracing for the worst, but behaving for the best: Social anxiety, hostility, and behavioral aggression. Journal of Anxiety Disorders, 24, 260–268.  https://doi.org/10.1016/j.janxdis.2009.12.002.CrossRefGoogle Scholar
  17. Dixon, L. J., Tull, M. T., Lee, A. A., Kimbrel, N. A., & Gratz, K. L. (2017). The role of emotion-driven impulse control difficulties in the relation between social anxiety and aggression. Journal of Clinical Psychology, 73, 722–732.  https://doi.org/10.1002/jclp.22372.CrossRefGoogle Scholar
  18. Endicott, N. A., & Endicott, J. (1963). Objective measures of somatic preoccupation. Journal of Nervous and Mental Disease, 137, 427–437.  https://doi.org/10.1097/00005053-196311000-00004.CrossRefGoogle Scholar
  19. Endicott, N. A., Jortner, S., & Abramoff, E. (1969). Objective measures of suspiciousness. Journal of Abnormal Psychology, 74, 26–32.  https://doi.org/10.1037/h0027066.CrossRefGoogle Scholar
  20. Erwin, B. A., Heimberg, R. G., Schneier, F. R., & Liebowitz, M. R. (2003). Anger experience and expression in social anxiety disorder: Pretreatment profile and predictors of attrition and response to cognitive-behavioral treatment. Behavior Therapy, 34, 331–350.  https://doi.org/10.1016/S0005-7894(03)80004-7.CrossRefGoogle Scholar
  21. Fenigstein, A., & Vanable, P. A. (1992). Paranoia and self-conscientiousness. Journal of Personality and Social Psychology, 62, 129–138.  https://doi.org/10.1037/0022-3514.62.1.129.CrossRefGoogle Scholar
  22. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2001). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
  23. Freeman, D. (2007). Suspicious minds: The psychology of persecutory delusions. Clinical Psychology Review, 27, 425–457.  https://doi.org/10.1016/j.cpr.2006.10.004.CrossRefGoogle Scholar
  24. Freeman, D., Garety, P. A., Kuipers, E., Fowler, D., & Bebbington, P. E. (2002). A cognitive model of persecutory delusions. British Journal of Clinical Psychology, 41, 331–347.  https://doi.org/10.1348/014466502760387461.CrossRefGoogle Scholar
  25. Freeman, D., Garety, P. A., Bebbington, P. E., Smith, B., Rollinson, R., Fowler, D., et al. (2005). Psychological investigation of the structure of paranoia in a non-clinical population. British Journal of Psychiatry, 186, 427–435.  https://doi.org/10.1192/bjp.186.5.427.CrossRefGoogle Scholar
  26. Gerevich, J., Bácskai, E., & Czobor, P. (2007). The generalizability of the Buss-Perry aggression questionnaire. International Journal of Methods in Psychiatric Research, 16, 124–136.  https://doi.org/10.1002/mpr.221.CrossRefGoogle Scholar
  27. Gershoff, E. T., Aber, J. L., Ware, A., & Kotler, J. A. (2010). Exposure to 9/11 among youth and their mothers in new York City: Enduring associations with mental health and sociopolitical attitudes. Child Development, 81, 1142–1160.  https://doi.org/10.1111/j.1467-8624.2010.01459.x.CrossRefGoogle Scholar
  28. Gilbert, P., Boxall, M., Cheung, M., & Irons, C. (2005). The relation of paranoid ideation and social anxiety in a mixed clinical population. Clinical Psychology & Psychotherapy, 12, 124–133.  https://doi.org/10.1002/cpp.438.CrossRefGoogle Scholar
  29. Goodwin, F. K., & Jamison, K. R. (2007). Manic-depressive illness: Bipolar disorders and recurrent depression (Vol.1). New York: Oxford University Press.Google Scholar
  30. Green, C. E. L., Freeman, D., Kuipers, E., Bebbington, P., Fowler, D., Dunn, G., & Garety, P. A. (2008). Measuring ideas of persecution and social reference: The Green et al. paranoid thought scales (GPTS). Psychological Medicine, 38, 101–111.  https://doi.org/10.1017/S0033291707001638.CrossRefGoogle Scholar
  31. Hawkins, K. A., & Cougle, J. R. (2011). Anger problems across the anxiety disorders: Findings from a population-based study. Depression and Anxiety, 28, 145–152.  https://doi.org/10.1002/da.20764.CrossRefGoogle Scholar
  32. Heimberg, R. G., & Turk, C. L. (2002). Assessment of social phobia. In R. G. Heimberg & R. E. Becker (Eds.), Cognitive-behavioral group therapy for social phobia: Basic mechanisms and clinical applications (pp. 107–126). New York, NY: Guilford Press.Google Scholar
  33. Heimberg, R. G., Brozovich, F. A., & Rapee, R. M. (2014). A cognitive-behavioral model of social anxiety disorder. In S. G. Hofmann & P. M. DiBartolo (Eds.), Social anxiety: Clinical, developmental, and social perspectives (pp. 705–728). London: Academic Press.CrossRefGoogle Scholar
  34. Hofmann, S. G., & Barlow, D. H. (2002). Social phobia (social anxiety disorder). In D. H. Barlow (Ed.), Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed., pp. 454–476). New York: Guilford Press.Google Scholar
  35. Hofmann, S. G., Heinrichs, N., & Moscovitch, D. A. (2004). The nature and expression of social phobia: Toward a new classification. Clinical Psychology Review, 24, 769–797.  https://doi.org/10.1016/j.cpr.2004.07.004.CrossRefGoogle Scholar
  36. Holtzman, W. H., Thorpe, J. S., Swartz, J. D., & Herron, E. W. (1961). Inkblot perception and personality: Holtzman inkblot technique. Austin: University of Texas Press.Google Scholar
  37. Johns, L. C., & van Os, J. (2001). The continuity of psychotic experiences in the general population. Clinical Psychology Review, 21, 1125–1141.  https://doi.org/10.1016/S0272-7358(01)00103-9.CrossRefGoogle Scholar
  38. Johnson-George, C., & Swap, W. C. (1982). Measurement of specific interpersonal trust: Construction and validation of a scale to assess trust in a specific other. Journal of Personality and Social Psychology, 43, 1306–1317.  https://doi.org/10.1037/0022-3514.43.6.1306.CrossRefGoogle Scholar
  39. Kachin, K. E., Newman, M. G., & Pincus, A. L. (2001). An interpersonal problem approach to the division of social phobia subtypes. Behavior Therapy, 32, 479–501.  https://doi.org/10.1016/S0005-7894(01)80032-0.CrossRefGoogle Scholar
  40. Kashdan, T. B., & Collins, R. L. (2010). Social anxiety and the experience of positive emotion and anger in everyday life: An ecological momentary assessment approach. Anxiety, Stress and Coping, 23, 259–272.  https://doi.org/10.1080/10615800802641950.CrossRefGoogle Scholar
  41. Kay, S. R., Flszbein, A., & Opfer, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261–276.CrossRefGoogle Scholar
  42. Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E. V. A., et al. (2005a). The World Health Organization adult ADHD self-report scale (ASRS): A short screening scale for use in the general population. Psychological Medicine, 35, 245–256.  https://doi.org/10.1017/S0033291704002892.CrossRefGoogle Scholar
  43. Kessler, R. C., Chiu, W. T., Demler, P., & Walters, E. E. (2005b). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627.  https://doi.org/10.1001/archpsyc.62.6.617.CrossRefGoogle Scholar
  44. Kirkpatrick, B. (1995). The study of paranoia and suspiciousness. Biological Psychiatry, 38, 496–497.  https://doi.org/10.1016/0006-3223(95)00388-w.CrossRefGoogle Scholar
  45. Leary, M. R., Twenge, J. M., & Quinlivan, E. (2006). Interpersonal rejection as a determinant of anger and aggression. Personality and Social Psychology Review, 10, 111–132.  https://doi.org/10.1207/s15327857pspr1002_2.CrossRefGoogle Scholar
  46. Lysaker, P. H., Davis, L. W., & Tsai, J. (2009). Suspiciousness and low self-esteem as predictors of misattributions of anger in schizophrenia spectrum disorders. Psychiatry Research, 166, 125–131.  https://doi.org/10.1016/j.psychres.2008.03.014.CrossRefGoogle Scholar
  47. Lysaker, P. H., Salvatore, G., Grant, M. L., Procacci, M., Olesek, K. L., Buck, K. D., Nicolò, G., & Dimaggio, G. (2010). Deficits in theory of mind and social anxiety as independent paths to paranoid features in schizophrenia. Schizophrenia Research, 124, 81–85.  https://doi.org/10.1016/j.schres.2010.06.019.CrossRefGoogle Scholar
  48. Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455–470.  https://doi.org/10.1016/S0005-7967(97)10031-6.CrossRefGoogle Scholar
  49. Mazeh, D., Bodner, E., Weizman, R., Delayahu, Y., Cholostoy, A., Martin, T., & Barak, Y. (2009). Co-morbid social phobia in schizophrenia. International Journal of Social Psychiatry, 55, 198–202.  https://doi.org/10.1177/0020764008093447.CrossRefGoogle Scholar
  50. McKay, R., Langdon, R., & Coltheart, M. (2006). The persecutory ideation questionnaire. Journal of Nervous and Mental Disease, 194, 628–631.  https://doi.org/10.1097/01.nmd.0000231441.48007.a5.CrossRefGoogle Scholar
  51. Michail, M., & Birchwood, M. (2009). Social anxiety disorder in first-episode psychosis: Incidence, phenomenology and relationship with paranoia. British Journal of Psychiatry, 195, 234–241.  https://doi.org/10.1192/bjp.bp.108.053124.CrossRefGoogle Scholar
  52. Moscovitch, D. A. (2009). What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioral Practice, 16, 123–134.  https://doi.org/10.1016/j.cbpra.2008.04.002.CrossRefGoogle Scholar
  53. Moscovitch, D. A., McCabe, R. E., Antony, M. M., Rocca, L., & Swinson, R. P. (2008). Anger experience and expression across the anxiety disorders. Depression and Anxiety, 25, 107–113.  https://doi.org/10.1002/da.20280.CrossRefGoogle Scholar
  54. Peters, E. R., Joseph, S. A., & Garety, P. A. (1999). Measurement of delusional ideation in the normal population: Introducing the PDI (Peters et al. delusions inventory). Schizophrenia Bulletin, 25, 553–576.CrossRefGoogle Scholar
  55. Pinto-Gouveia, J., Castilho, P., Galhardo, A., & Cunha, M. (2006). Early maladaptive schemas and social phobia. Cognitive Therapy and Research, 30, 571–584.  https://doi.org/10.1007/s10608-006-9027-8.CrossRefGoogle Scholar
  56. Pisano, S., Catone, G., Pascotto, A., Iuliano, R., Tiano, C., Milone, A., et al. (2015). Paranoid thoughts in adolescents with social anxiety disorder. Child Psychiatry & Human Development, 47, 792–798.  https://doi.org/10.1007/s10578-015-0612-5.CrossRefGoogle Scholar
  57. Raine, A. (1991). The SPQ: A scale for the assessment of schizotypal personality based on DSM-III-R criteria. Schizophrenia Bulletin, 17, 555–564.  https://doi.org/10.1093/schbul/17.4.555.CrossRefGoogle Scholar
  58. Rawlings, D., & Freeman, J. L. (1996). A questionnaire for the measurement of paranoia/suspiciousness. British Journal of Clinical Psychology, 35, 451–461.  https://doi.org/10.1111/j.2044-8260.1996.tb01199.x.CrossRefGoogle Scholar
  59. Shields, M. (2004). Social anxiety disorder - beyond shyness. Statistics Canada Catalogue, 15, 47–81.Google Scholar
  60. Spielberger, C. D. (1988). Manual for the State-Trait Anger Expression Inventory (STAXI). Odessa: Psychological Assessment Resources.Google Scholar
  61. Spielberger, C. D., Jacobs, G., Russell, S., & Crane, R. S. (1983). Assessment of anger: The state-trait anger scale. In J. N. Butaker & C. D. Spielberger (Eds.), Advances in personality assessment Vol. 2. Hillside: Lawrence Erlbaum Associates.Google Scholar
  62. Spielberger, C. D., Johnson, E. H., Russell, S. F., Crane, R. J., Jacobs, G. A., & Worden, T. J. (1985). The experience and expression of anger: Construction and validation of an anger expression scale. In M. A. Chesney & R. H. Rosenman (Eds.), Anger and hostility in cardiovascular and behavioral disorders (pp. 5–30). New York: Hemisphere/McGraw-Hill.Google Scholar
  63. Taylor, K. N., & Stopa, L. (2013). The fear of others: A pilot study of social anxiety processes in paranoia. Behavioural and Cognitive Psychotherapy, 41, 66–88.  https://doi.org/10.1017/S1352465812000690.CrossRefGoogle Scholar
  64. Tone, E. B., Goulding, S. M., & Compton, M. T. (2011). Associations among perceptual anomalies, social anxiety, and paranoia in a college student sample. Psychiatry Research, 188, 258–263.  https://doi.org/10.1016/j.psychres.2011.03.023.CrossRefGoogle Scholar
  65. Twenge, J. M., Baumeister, R. F., Tice, D. M., & Stucke, T. S. (2001). If you can't join them, beat them: Effects of social exclusion on aggressive behavior. Journal of Personality and Social Psychology, 81, 1058–1069.  https://doi.org/10.1037/0022-3514.81.6.1058.CrossRefGoogle Scholar
  66. van Os, J., Verdoux, H., Maurice-Tison, S., Gay, B., Liraud, F., Salamon, R., & Bourgeois, M. (1999). Self-reported psychosis-like symptoms and the continuum of psychosis. Social Psychiatry and Psychiatric Epidemiology, 34, 459–463.  https://doi.org/10.1007/s001270050220.CrossRefGoogle Scholar
  67. Versella, M. V., Piccirillo, M. L., Potter, C. M., Olino, T. M., & Heimberg, R. G. (2016). Anger profiles in social anxiety disorder. Journal of Anxiety Disorders, 37, 21–29.  https://doi.org/10.1016/j.janxdis.2015.10.008.CrossRefGoogle Scholar
  68. Weeks, J. W., Heimberg, R. G., & Rodebaugh, T. L. (2008). The fear of positive evaluation scale: Assessing a proposed cognitive component of social anxiety. Journal of Anxiety Disorders, 22, 44–55.  https://doi.org/10.1016/j.janxdis.2007.08.002.CrossRefGoogle Scholar
  69. White, S. W., Kreiser, N. L., Pugliese, C., & Scarpa, A. (2012). Social anxiety mediates the effect of autism spectrum disorder characteristics on hostility in young adults. Autism, 16, 453–464.  https://doi.org/10.1177/1362361311431951.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychologyRyerson UniversityTorontoCanada
  2. 2.Anxiety Treatment and Research Clinic, St. Joseph’s Healthcare Hamilton, and Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonCanada

Personalised recommendations