Validation of the Social Appearance Anxiety Scale in patients with systemic sclerosis: A Scleroderma Patient-centered Intervention Network Cohort study

Contains fulltext : 195880.pdf (publisher's version ) (Closed access)Objective: Systemic sclerosis (SSc) is an autoimmune disease that can cause disfiguring changes in appearance. This study examined the structural validity, internal consistency reliability, convergent validity, and measurement equivalence of the Social Appearance Anxiety Scale (SAAS) across SSc disease subtypes. Methods: Patients enrolled in the Scleroderma Patient-centered Intervention Network Cohort completed the SAAS and measures of appearance-related concerns and psychological distress. Confirmatory factor analysis (CFA) was used to examine the structural validity of the SAAS. Multiple-group CFA was used to determine if SAAS scores can be compared across patients with limited and diffuse disease subtypes. Cronbach's alpha was used to examine internal consistency reliability. Correlations of SAAS scores with measures of body image dissatisfaction, fear of negative evaluation, social anxiety, and depression were used to examine convergent validity. SAAS scores were hypothesized to be positively associated with all convergent validity measures, with correlations significant and moderate to large in size. Results: A total of 938 patients with SSc were included. CFA supported a one-factor structure (CFI: .92; SRMR: .04; RMSEA: .08), and multiple-group CFA indicated that the scalar invariance model best fit the data. Internal consistency reliability was good in the total sample (α = .96) and in disease subgroups. Overall, evidence of convergent validity was found with measures of body image dissatisfaction, fear of negative evaluation, social anxiety, and depression. Conclusion: The SAAS can be reliably and validly used to assess fear of appearance evaluation in patients with SSc, and SAAS scores can be meaningfully compared across disease subtypes.6 p

Validation of the Brief Fear of Negative Evaluation Scale-II in patients with systemic sclerosis: A Scleroderma Patient-centered Intervention Network Cohort study

Item does not contain fulltextObjective: Fear of negative evaluation is a common concern among individuals with visible differences but has received limited attention in systemic sclerosis (SSc), which can involve substantial changes to appearance. The Brief Fear of Negative Evaluation Scale (BFNE) was specifically designed to evaluate fear of negative evaluation. There are currently three versions of the BFNE with strong demonstrated measurement properties: two eight-item versions (BFNE-S, BFNE-8) and one 12-item version (BFNE-II). The present study evaluated these versions in SSc, and identified the most appropriate version for use among SSc patients. Methods: Participants were 1010 patients with SSc enrolled in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort. Multiple group confirmatory factor analysis, Cronbach's alpha, and Pearson product-moment correlations were used to evaluate structural validity, internal consistency reliability, and convergent and divergent validity, respectively. Results: Confirmatory factor analysis demonstrated that one-factor models fit acceptably well for the 12-item BFNE-II, the eight-item BFNE-S, and the eight-item BFNE-8. All Cronbach's alphas were excellent (BFNE-II: 0.98; BFNE-S: 0.97; BFNE-8: 0.96), and all versions had comparable associations with measures of social anxiety, body-related attitudes, depression, age, and education. Conclusion: Psychometric support was found for all three versions of the BFNE, though the longer 12-item BFNE-II did not improve measurement compared to the shorter eight-item versions. Of these two, the BFNE-S has been more widely studied with strong validity data in a greater number of populations. Therefore, the BFNE-S is recommended to assess fear of negative evaluation among patients with SSc.7 p