Validation of the Social Interaction Anxiety Scale in scleroderma: a Scleroderma Patient-centered Intervention Network Cohort study



Individuals with visible differences due to medical conditions, such as systemic sclerosis (SSc; scleroderma), have reported difficulty navigating social situations because of issues such as staring, invasive questions, and rude comments. Fears or anxiety linked to situations in which a person interacts with others is known as social interaction anxiety. However, there exists no validated measurement tool to examine social interaction anxiety in rheumatologic conditions.


The present study examines the reliability (internal consistency) and validity (structural and convergent) of the Social Interaction Anxiety Scale-6 (SIAS-6) in a sample of 802 individuals with SSc, and compares these psychometric properties across limited and diffuse subtypes of the disease. Multi-group confirmatory factor analysis was used to examine the factor structure of the SIAS-6 in patients with both limited and diffuse SSc.


A one-factor structure was found to fit well for individuals with SSc with both limited and diffuse disease. The measure demonstrated strong internal consistency reliability and convergent validity with relevant measures in expected magnitudes and directions.


The SIAS-6 is a psychometrically robust measure that can confidently be used in SSc populations to examine social interaction anxiety. Moreover, scores can meaningfully be compared between patients with limited and diffuse disease.

Post author correction


Article Subject: Psychology and Social Phenomena



Shadi Gholizadeh, Linda Kwakkenbos, Marie-Eve Carrier, Sarah D. Mills, Rina S. Fox, Lisa R. Jewett, Karen Gottesman, Scott Roesch, Brett D. Thombs, Vanessa L. Malcarne, SPIN Investigators

Article History


Financial support: The Scleroderma Patient-centered Intervention Network (SPIN) is funded by a Canadian Institutes of Health Research (CIHR) Emerging Team Grant for Rare Diseases (PI, Thombs; TR3-119192). In addition to CIHR funding, SPIN has received institutional contributions from the Lady Davis Institute for Medical Research of the Jewish General Hospital, Montréal, Canada and from McGill University, Montréal, Canada. SPIN has also received support from the Scleroderma Society of Ontario, Scleroderma Canada, and Sclérodermie Québec. Ms. Gholizadeh’s work on this project was supported by a Rheumatology Research Foundation: Health Professional Research Preceptorship. Dr. Kwakkenbos was supported by a CIHR Banting Postdoctoral Fellowship. Ms. Jewett was supported by a CIHR Doctoral Research Award. Dr. Thombs was supported by an Investigator Salary Award from the Arthritis Society.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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  • San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California - USA
  • Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec - Canada
  • Department of Psychiatry, McGill University, Montreal, Quebec - Canada
  • Behavioral Science Institute, Clinical Psychology, Radboud University, Nijmegen - The Netherlands
  • Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec - Canada
  • Scleroderma Foundation, Los Angeles, California - USA
  • Department of Psychology, San Diego State University, San Diego, California - USA
  • Departments of Biostatistics and Occupational Health, McGill University, Montreal, Quebec - Canada
  • The complete list of SPIN investigators is available in the Acknowledgements section.

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