Kutcher Generalized Social Anxiety Disorder Scale for Adolescents (K-GSADS-A)

The Kutcher Generalized Social Anxiety Scale for Adolescents (K-GSAD-A) is an instrument developed to monitor the symptom severity of social anxiety problems in children or adolescents (11-17 years of age) over time (Brooks & Kutcher, 2004). It was developed by Professor Stanley Kutcher (an expert in child and adolescent mental health) in conjunction with input from doctors and nurses with many years’ experience in treating and monitoring the symptoms of adolescents with social anxiety. When it was developed in 1999, no such clinician-rated scales existed. Psychometric properties of this scale were evaluated in a later drug trial study using adolescent subjects from the USA, South Africa, Canada and Belgium (Brooks & Kutcher, 2004).

Psychometric Properties

Items

The K-GSAD-A has three sections. In section A there are 18 items relating to fear and avoidance (of social situations). Each item is rated on two scales, the first being discomfort/anxiety/distress experienced, and the second being avoidance. Items are rated using a four-point scale of strength of fear/avoidance, ranging from 0= ‘never’, 1= ‘mild’, 2= ‘moderate’, and 3= ‘severe’. In section B, the respondent is asked for three of their most feared social situations which are also rated on the above four-point scales. Section C consists of 11 items relating to affective and somatic distress measured on the same scale.

Reliability

Cronbach’s alphas of the instrument (subscales and total) averaged between .74 and .96 across the 5 assessments times of the 16 week trial. Thus the internal consistency was at least acceptable (in most social science research), and is in the majority of cases excellent.

Test-retest reliability was found to be on the lower end of adequate, as adolescents in the placebo condition had a test-retest intraclass correlation of .64 across a 4-week interval. This means that the adolescents that did not receive the drug had a somewhat similar score at baseline and at 4 weeks, meaning that there was a minimal level of consistency and reproducibility.

Validity

There were moderate correlations between the K-GSADS-A Total Score (see below) and two illness-nonspecific clinician rated measures in the expected direction (see Brooks & Kutcher, 2004). There was also a very strong correlation between the K-GSADS-A and another clinician rated measure of paediatric social anxiety (the LSAS-CA) which was new and recently validated when this paper was written. The K-GSADS-A additionally strongly correlated with a scale designed very similarly to itself, however was self-reported (the SPAI; Brooks & Kutcher, 2004). All the above correlations therefore demonstrated convergent validity. On the other hand, a depression measure was shown to correlate weakly indicating divergent validity.

Sensitivity to change

Changes between the 5 assessment occasions mirrored corresponding changes in other instruments (see Brooks & Kutcher, 2004)

Subscale scores

The Fear and Anxiety Score is made of Items A 1-18, using the anxiety column. The Avoidance Score is made of Items A 1-18, using the avoidance column. The Affective Distress Score is made of Items C 1-5, while the Somatic Distress Score is made of Items C 6 – 11. The Total K-GSADS-A Score is made of the addition of the four subscale scores.

Interpretation of scores

Diagnostic categories are not associated with particular score ranges. Rather, scores should be assessed in relation to the young person’s baseline score to see if there is a worsening of social anxiety (increase in scores) or a possible improvement (reduction in score).

Access and uses

K-GSADS-A is available at no cost at http://teenmentalhealth.org/product/kutcher-generalized-social-anxiety-scale-adolescents-kgsads/ under ‘toolbox’. Suitable administrators include mental health specialists, as well as doctors, nurses and social workers who have experience working with socially anxious adolescents. More recently, the test has been use in a normative sample in Pakistan to show that female adolescents have an increased level of social anxiety compared to males (Inam, Khalil, Tahir, & Abioudullah, 2014). A negative correlation with social anxiety and emotional intelligence was also found (Inam et al., 2014.

References