Validation of the Social Appearance Anxiety Scale in Patients With Systemic Sclerosis: A Scleroderma Patient-Centered Intervention Network Cohort Study

and the Scleroderma Patient-Centered Intervention Network Investigators

Research output: Contribution to journalArticle

Abstract

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 whether 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 1-factor structure (Comparative Fit Index 0.92, Standardized Root Mean Residual 0.04, and Root Mean Square Error of Approximation 0.08), and multiple-group CFA indicated that the scalar invariance model best fit the data. Internal consistency reliability was good in the total sample (α = 0.96) 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.

Original languageEnglish (US)
Pages (from-to)1557-1562
Number of pages6
JournalArthritis Care and Research
Volume70
Issue number10
DOIs
StatePublished - Oct 1 2018

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Systemic Scleroderma
Cohort Studies
Anxiety
Statistical Factor Analysis
Fear
Body Image
Depression
Reproducibility of Results
Autoimmune Diseases
Psychology

ASJC Scopus subject areas

  • Rheumatology

Cite this

Validation of the Social Appearance Anxiety Scale in Patients With Systemic Sclerosis : A Scleroderma Patient-Centered Intervention Network Cohort Study. / and the Scleroderma Patient-Centered Intervention Network Investigators.

In: Arthritis Care and Research, Vol. 70, No. 10, 01.10.2018, p. 1557-1562.

Research output: Contribution to journalArticle

and the Scleroderma Patient-Centered Intervention Network Investigators. / Validation of the Social Appearance Anxiety Scale in Patients With Systemic Sclerosis : A Scleroderma Patient-Centered Intervention Network Cohort Study. In: Arthritis Care and Research. 2018 ; Vol. 70, No. 10. pp. 1557-1562.
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abstract = "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 whether 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 1-factor structure (Comparative Fit Index 0.92, Standardized Root Mean Residual 0.04, and Root Mean Square Error of Approximation 0.08), and multiple-group CFA indicated that the scalar invariance model best fit the data. Internal consistency reliability was good in the total sample (α = 0.96) 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.",
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T1 - Validation of the Social Appearance Anxiety Scale in Patients With Systemic Sclerosis

T2 - A Scleroderma Patient-Centered Intervention Network Cohort Study

AU - and the Scleroderma Patient-Centered Intervention Network Investigators

AU - Mills, Sarah D.

AU - Kwakkenbos, Linda

AU - Carrier, Marie Eve

AU - Gholizadeh, Shadi

AU - Fox, Rina S.

AU - Jewett, Lisa R.

AU - Gottesman, Karen

AU - Roesch, Scott C.

AU - Thombs, Brett D.

AU - Malcarne, Vanessa L.

AU - Baron, Murray

AU - Bartlett, Susan J.

AU - Ells, Carolyn

AU - Hudson, Marie

AU - Jang, Yeona

AU - Körner, Annett

AU - Furst, Dan

AU - Kafaja, Suzanne

AU - van den Hoogen, Frank

AU - Mayes, Maureen D.

AU - Assassi, Shervin

AU - Mouthon, Luc

AU - Nielson, Warren R.

AU - Riggs, Robert

AU - Sauve, Maureen

AU - Fortune, Catherine

AU - Nielsen, Karen

AU - Wigley, Fredrick

AU - Boutron, Isabelle

AU - Maia, Angela Costa

AU - Leite, Catarina

AU - El-Baalbaki, Ghassan

AU - van den Ende, Cornelia

AU - Fligelstone, Kim

AU - Frech, Tracy

AU - Godard, Dominique

AU - Harel, Daphna

AU - Impens, Ann

AU - Johnson, Sindhu R.

AU - Kennedy, Ann Tyrell

AU - Larche, Maggie

AU - Khalidi, Nader

AU - Marra, Carlo

AU - Pope, Janet

AU - Portales, Alexandra

AU - Rodriguez Reyna, Tatiana Sofia

AU - Luna, David

AU - Schouffoer, Anne A.

AU - Steele, Russell J.

AU - Gyger, Genevieve

PY - 2018/10/1

Y1 - 2018/10/1

N2 - 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 whether 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 1-factor structure (Comparative Fit Index 0.92, Standardized Root Mean Residual 0.04, and Root Mean Square Error of Approximation 0.08), and multiple-group CFA indicated that the scalar invariance model best fit the data. Internal consistency reliability was good in the total sample (α = 0.96) 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.

AB - 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 whether 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 1-factor structure (Comparative Fit Index 0.92, Standardized Root Mean Residual 0.04, and Root Mean Square Error of Approximation 0.08), and multiple-group CFA indicated that the scalar invariance model best fit the data. Internal consistency reliability was good in the total sample (α = 0.96) 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.

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