Cross-cultural adaptation and validation of the Liebowitz Social Anxiety Scale (LSAS-SR) Tamil Version

Abstract

Background: Despite being the third most prevalent psychiatric disorder, social anxiety disorder remains under-diagnosed due to multiple reasons. Although many screening instruments are available in the English language, to date no instrument has been translated into Tamil. Objective: To translate and validate the Liebowitz Social Anxiety Scale (LSAS-SR) into Tamil among a group of Sri Lankan university students whose mother tongue is Tamil. Method: The process of translation and validation involved standard procedures. DSM- 5 was used as the gold standard to diagnose social anxiety disorder. As part of the psychometric study, test-retest reliability and analysis of items for internal consistency of the instrument were assessed. Results: A cut off of55.5had the optimum sensitivity and specificity for the Tamil version of the LSAS-SR. The Cronbach’s alpha between the avoidance subscaletotal and the fear subscale total was 0.860 while the figures for Cronbach’s alpha between the total score and fear subscale total score and the avoidance subscale total score were 0.880 and 0.855, respectively. The test- retest reliability correlation coefficients for the fear subscale, avoidance subscale and the total score were 0.890, 0.925 and 0.918, respectively (p<0.001 for all). Conclusions: The cut off score of 55.5had the optimum sensitivity and specificity for the LSAS-SR Tamil version. It had good internal consistency and test-retest reliability. Further studies will enable the assessment of the prevalence of social phobia and investigation of cultural and environmental factors associated with social phobia in Sri Lanka.