LSAS: Scoring Guide and Severity Cutoffs · Liebowitz Social Anxiety Scale
The LSAS (Liebowitz Social Anxiety Scale) is a 24-item clinician-administered rating scale, with a self-report version (LSAS-SR), that measures fear and avoidance across 13 performance and 11 social interaction situations in social anxiety disorder. Total score 0–144; Mennin et al. (2002) cutoffs are 30 for social anxiety disorder and 60 for its generalized subtype.
For professional reference, research, and education only. Not for diagnosis or medical advice.
LSAS Total Score Interpreter
Enter a total score to see its range.
24 items, each rated 0–3 for fear/anxiety and 0–3 for avoidance across 13 performance and 11 social-interaction situations. Higher totals indicate more pervasive social anxiety. Educational reference — not a diagnosis.
Total score Interpretation 95+ Very severe social anxietyPervasive fear and avoidance across nearly all social and performance situations. Well above the generalized-subtype screening cutoff of 60 (Mennin 2002); clinical evaluation is warranted. 80–94 Severe social anxietyMarked impairment across most situations. Comprehensive clinician assessment is indicated. 65–79 Marked social anxietySubstantial fear and avoidance. Above the generalized-subtype cutoff of 60 (Mennin 2002), suggesting broad rather than circumscribed social fears. 50–64 Moderate social anxietyClinically meaningful symptoms. Above the screening cutoff of 30 for social anxiety disorder (Mennin 2002); formal assessment is appropriate. 30–49 Mild social anxietyAt or above the screening cutoff of 30 for social anxiety disorder (Mennin 2002) but below the generalized-subtype cutoff of 60; formal assessment is appropriate. 0–29 No/minimal social anxietyBelow the screening cutoff of 30 (Mennin 2002). Symptoms are unlikely to meet criteria for social anxiety disorder, though a low score does not rule it out. Empirical screening cutoffs of 30 (social anxiety disorder) and 60 (generalized subtype) are from Mennin et al. (2002), validated for the self-report form by Rytwinski et al. (2009). The descriptive severity bands below are commonly-used clinical conventions, not thresholds from a single validation study.
The LSAS (Liebowitz Social Anxiety Scale) is a 24-item rating scale that measures fear and avoidance across 13 performance and 11 social interaction situations in social anxiety disorder. Totals run from 0 to 144, and 30 is the usual screening cutoff [3].
What does the LSAS measure?
The LSAS was developed by Michael Liebowitz in 1987 to assess the range of social situations that may be feared or avoided by people with social anxiety disorder (SAD), also known as social phobia [1]. It covers performance situations (public speaking, eating in public) and social interaction situations (parties, meeting strangers, eye contact).
It is one of the most commonly used clinician-administered scales for social phobia, and it is sensitive to the effects of medication in treatment trials [2].
How do you give the LSAS?
The original LSAS is clinician-administered, with an assessor rating each situation. A self-report version (LSAS-SR) is also widely used, and the same screening cutoffs apply to it [4].
Each of the 24 situations is rated on two independent dimensions: fear/anxiety (0 = none to 3 = severe) and avoidance (0 = never to 3 = usually).
LSAS situation categories
The 24 LSAS situations span two broad domains. Each is rated independently for fear and avoidance.
Performance situations (13)
Performance situations involve being observed or evaluated while doing something. The 13 LSAS performance items are:
- telephoning in public
- participating in small groups
- eating in public
- drinking in public
- talking to people in authority
- acting, performing, or giving a talk in front of an audience
- working while being observed
- writing while being observed
- entering a room when others are already seated
- speaking up at a meeting
- taking a test of ability or competence
- giving a report to a group
- trying to pick up someone
Social interaction situations (11)
Social interaction situations involve starting or sustaining contact with others. The 11 LSAS social-interaction items are:
- going to a party
- meeting strangers
- using a public restroom
- talking with people you do not know well
- expressing disagreement or disapproval to people you do not know well
- looking at people you do not know well in the eyes
- returning goods to a store
- giving a party
- resisting a high-pressure salesperson
- talking face-to-face with someone you do not know well
- being the centre of attention
How do you score and interpret the LSAS?
The total is the sum of all 48 ratings: fear/anxiety (0–72) and avoidance (0–72) across the 24 situations, giving a range of 0 to 144. Scoring also gives four subscale scores.
The two empirically validated screening anchors come from a study of the clinician-administered LSAS: a total of 30 best identifies social anxiety disorder, and 60 best identifies its generalized subtype [3].
Definitions of treatment response and remission vary across trials and have not converged on a single agreed value.
Total score severity reference
The total score is most often read against the two screening cutoffs plus a descriptive severity ladder. The cutoffs of 30 and 60 are ROC-derived [3] and were replicated for the self-report form [4]. The severity labels below are a commonly used clinical convention rather than thresholds from a single validation study, so treat the band edges as approximate.
| Total score | Interpretation |
|---|---|
| 0–29 | No/minimal social anxiety (below the screening cutoff) |
| 30–49 | Mild: at or above the screening cutoff of 30 for social anxiety disorder |
| 50–64 | Moderate |
| 65–79 | Marked (at or above 60, the cutoff for the generalized subtype) |
| 80–94 | Severe |
| ≥95 | Very severe |
Four subscales
The LSAS yields four subscale scores in addition to the total. Each situation is rated for fear/anxiety (0–3) and avoidance (0–3), and the 24 situations split into 13 performance and 11 social-interaction situations. The four subscales are formed by crossing the two rating dimensions with the two situation domains.
| Subscale | Items | Range |
|---|---|---|
| Total fear/anxiety | 24 | 0–72 |
| Total avoidance | 24 | 0–72 |
| Performance fear/anxiety | 13 | 0–39 |
| Performance avoidance | 13 | 0–39 |
| Social-interaction fear/anxiety | 11 | 0–33 |
| Social-interaction avoidance | 11 | 0–33 |
In clinical samples the fear and avoidance subscales may not be sufficiently distinct [2], so the total score is generally the most useful summary.
Psychometric properties
- Reliability and validity: in 382 participants from social phobia treatment studies, the LSAS and its subscales showed excellent internal consistency and convergent validity with other measures of social anxiety and avoidance, with correlations tending to be larger than those with depression measures [2].
- Treatment sensitivity: the LSAS was sensitive to pharmacological treatment over time and in comparison to double-blind pill placebo [2].
- Screening accuracy: ROC analysis in 364 adults with SAD and 34 controls found cutoffs of 30 (SAD) and 60 (generalized subtype) gave the best balance of sensitivity and specificity [3]. The same cutoffs were optimal for the self-report LSAS-SR [4].
Limitations
- Screening, not diagnosis. Cutoffs of 30 and 60 are screening thresholds; a structured clinical interview is required to confirm social anxiety disorder.
- Subscale overlap. The fear and avoidance subscales may not be sufficiently distinct in clinical samples [2], so the total score is the most reliable summary.
- Severity bands are conventions. The descriptive bands above 30 (moderate, marked, severe, very severe) are not thresholds from a single validation study.
- Validated samples. The 1999 psychometric study called for further work in samples with severe social phobia and in community samples [2].
Social anxiety assessment tools
The LSAS is one of several validated measures for social anxiety, and clinicians often pair or substitute it depending on setting and goal:
- Social Phobia Inventory (SPIN): a 17-item self-report screen; brief and convenient for routine intake.
- Social Interaction Anxiety Scale (SIAS) and Social Phobia Scale (SPS): companion measures separating interaction-based from scrutiny-based fears.
- Brief Fear of Negative Evaluation (BFNE): a focused measure of the core cognitive feature of social anxiety.
- Mini-SPIN: a 3-item ultra-brief screen for high-volume primary care.
The LSAS remains the field standard for treatment trials because it covers both fear and avoidance across a broad range of situations and is sensitive to change over time [2].
For individuals: This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
Billing
In the US, the LSAS: Scoring Guide and Severity Cutoffs · Liebowitz Social Anxiety Scale is usually billed under these CPT codes. Payer rules vary.
- Publisher
- Michael R. Liebowitz (1987)
- First published
- 1987
- Terms
- Use outside individual clinical or research settings requires permission from the copyright holder.
References
- 1.Liebowitz MR. Social phobia. Mod Probl Pharmacopsychiatry. 1987;22:141-173.View source
- 2.Heimberg RG, Horner KJ, Juster HR, et al. Psychometric properties of the Liebowitz Social Anxiety Scale. Psychol Med. 1999;29(1):199-212.View source
- 3.Mennin DS, Fresco DM, Heimberg RG, et al. Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale. J Anxiety Disord. 2002;16(6):661-673.View source
- 4.Rytwinski NK, Fresco DM, Heimberg RG, et al. Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depress Anxiety. 2009;26(1):34-38.View source
LSAS © Michael R. Liebowitz (1987). Use outside individual clinical or research settings requires permission from the copyright holder.
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Related
Assessments
Common paths
- Cognitive Behavioural Therapy
Individual CBT had the largest effect of the psychological treatments and beat psychological placebo in a network meta-analysis of 101 trials with 13,164 participants.
Mayo-Wilson E, et al. Lancet Psychiatry. 2014;1(5):368–76.
- Cognitive Behavioural Therapy
FAQ
What is a high LSAS score?
On the LSAS total score (range 0–144), higher numbers reflect more pervasive social fear and avoidance. A widely used descriptive convention treats scores at or above 65 as marked, 80 as severe, and 95 as very severe social anxiety. Empirically, Mennin et al. (2002) found a total of 60 best identified the generalized subtype of social anxiety disorder.
Is the LSAS self-report or clinician-administered?
Both versions exist. The original LSAS is clinician-administered, with an assessor rating each situation. A self-report version (LSAS-SR) is also widely used; Rytwinski et al. (2009) found the same screening cutoffs (30 and 60) apply, and its authors describe it as an accurate and cost-effective way to identify social anxiety disorder.
What LSAS score suggests social anxiety disorder?
Mennin et al. (2002) reported that a total LSAS score of 30 provided the best balance of sensitivity and specificity for identifying social anxiety disorder, and a score of 60 best identified the generalized subtype. These are screening thresholds, not a diagnosis — a structured clinical interview is required to confirm.
How is the LSAS scored?
Each of the 24 situations is rated on two 0–3 scales: fear/anxiety (0 = none to 3 = severe) and avoidance (0 = never to 3 = usually, 67–100%). Summing all 48 ratings yields a total of 0–144, alongside four subscale scores (fear and avoidance, each split into performance and social-interaction situations).
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