[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"assessment-social-anxiety-test":3,"all-assessments-nav":418,"related-assessments-query":1065},{"id":4,"title":5,"body":6,"category":353,"categoryTitle":354,"clinicalCitations":355,"copyright":353,"description":365,"disclaimer":353,"downloadLink":353,"extension":366,"faqs":367,"featured":383,"i18nReady":383,"icon":353,"interpreter":384,"lastReviewed":408,"meta":409,"navigation":410,"path":411,"permissionsNote":353,"published":383,"recommendedFrequency":353,"relatedCodes":353,"relatedConditions":353,"reviewedBy":353,"seo":412,"slug":413,"stem":414,"summary":415,"takeaways":353,"timeline":353,"type":416,"usedToDiagnose":353,"__hash__":417},"assessments\u002Fassessments\u002Fsocial-anxiety-test.md","Social Anxiety Test (SPIN Score Guide)",{"type":7,"value":8,"toc":339},"minimark",[9,13,18,21,24,27,31,34,37,40,44,47,52,130,133,137,140,193,200,204,212,238,242,329,332,336],[10,11,12],"p",{},"A social anxiety test screens for Social Anxiety Disorder (SAD), intense fear of social scrutiny, embarrassment, or humiliation. Key tools: SPIN (17 items), Mini-SPIN (3 items), and LSAS (24 situations). 7–13% lifetime prevalence. DSM-5-TR (APA, 2022).",[14,15,17],"h2",{"id":16},"what-is-social-anxiety","What is Social Anxiety?",[10,19,20],{},"Social Anxiety Disorder (SAD), also known as social phobia,\nis characterized by intense, persistent fear of one or more social or\nperformance situations in which the person is exposed to possible\nscrutiny by others. The core fear is of acting in a way, or showing anxiety\nsymptoms, that will be negatively evaluated, resulting in humiliation,\nembarrassment, or rejection.",[10,22,23],{},"SAD is the third most common mental health condition globally,\naffecting 7–13% of the population over a lifetime. It typically begins in early\nto middle adolescence (median onset age 13) and follows a chronic, unremitting\ncourse without treatment. Adults with SAD often report years of avoidance and\nmissed opportunities in social, academic, and occupational domains before\nseeking help, if they seek help at all.",[10,25,26],{},"Cognitive Behavioural Therapy (CBT), particularly exposure-based\nCBT (Clark & Wells model; Heimberg model), is the first-line, evidence-based treatment,\nwith response rates of 70–80%. SSRIs (escitalopram, sertraline,\nparoxetine) are first-line pharmacological treatments. The combination of CBT\nand SSRIs is not consistently more effective than either alone. Early\ntreatment is strongly associated with better outcomes and reduced\nsecondary complications (depression, substance use).",[14,28,30],{"id":29},"spin-score-interpreter","SPIN Score Interpreter",[10,32,33],{},"Enter your Social Phobia Inventory (SPIN) total score (0–68). SPIN ≥19 is the validated screening cutoff for Social Anxiety Disorder. Connor et al. (2000).",[10,35,36],{},"17 items rated 0–4 (Not at all \u002F A little \u002F Somewhat \u002F Very much \u002F Extremely). Three subscales: Fear (7 items), Avoidance (7 items), Physiological (3 items).",[10,38,39],{},"SPIN © Connor et al. (2000). Available for clinical and research use. A positive SPIN screen does not diagnose SAD, clinical diagnosis requires structured interview. GAD-7 item 6 can also flag social anxiety. For LSAS score interpretation, see our LSAS page.",[14,41,43],{"id":42},"spin-score-reference","SPIN Score Reference",[10,45,46],{},"In the original validation study, Connor et al. (2000) found that a SPIN total of 19 distinguished people with social phobia from controls, so ≥19 is the commonly cited screening cutoff. The severity bands below are a widely used clinical convention for interpreting the 0–68 range; they were not defined in the original paper. Higher totals reflect more intense fear, avoidance, and physiological symptoms.",[48,49,51],"h3",{"id":50},"spin-severity-bands","SPIN Severity Bands",[53,54,55,71],"table",{},[56,57,58],"thead",{},[59,60,61,65,68],"tr",{},[62,63,64],"th",{},"SPIN total",[62,66,67],{},"Severity band",[62,69,70],{},"Interpretation",[72,73,74,86,97,108,119],"tbody",{},[59,75,76,80,83],{},[77,78,79],"td",{},"0–20",[77,81,82],{},"None \u002F minimal",[77,84,85],{},"Below the common ≥19 screening cutoff; social anxiety unlikely to be clinically significant.",[59,87,88,91,94],{},[77,89,90],{},"21–30",[77,92,93],{},"Mild",[77,95,96],{},"Above the screening cutoff; mild social anxiety symptoms.",[59,98,99,102,105],{},[77,100,101],{},"31–40",[77,103,104],{},"Moderate",[77,106,107],{},"Moderate social anxiety symptoms.",[59,109,110,113,116],{},[77,111,112],{},"41–50",[77,114,115],{},"Severe",[77,117,118],{},"Severe social anxiety symptoms; clinical evaluation recommended.",[59,120,121,124,127],{},[77,122,123],{},"51–68",[77,125,126],{},"Very severe",[77,128,129],{},"Very severe social anxiety symptoms; full clinical evaluation strongly indicated.",[10,131,132],{},"The ≥19 screening cutoff is from Connor et al. (2000). The band ranges above are a commonly used clinical convention for the 0–68 SPIN scale and are not specified in the source paper, so treat them as an interpretive guide rather than fixed diagnostic thresholds.",[48,134,136],{"id":135},"dsm-5-tr-core-features","DSM-5-TR Core Features",[10,138,139],{},"The DSM-5-TR (APA, 2022) defines Social Anxiety Disorder (social phobia) by the following core features:",[141,142,143,151,157,166,172,181,187],"ul",{},[144,145,146,150],"li",{},[147,148,149],"strong",{},"Marked fear or anxiety"," about one or more social situations in which the person may be scrutinized by others — for example conversations, meeting unfamiliar people, being observed eating or drinking, or performing in front of others.",[144,152,153,156],{},[147,154,155],{},"Fear of negative evaluation:"," the individual fears that they will act in a way, or show anxiety symptoms, that will be negatively judged (humiliating, embarrassing, or leading to rejection or offending others).",[144,158,159,162,163],{},[147,160,161],{},"The social situations almost always provoke fear or anxiety"," and are ",[147,164,165],{},"avoided or endured with intense distress.",[144,167,168,171],{},[147,169,170],{},"The fear or anxiety is out of proportion"," to the actual threat posed by the situation and to the sociocultural context.",[144,173,174,177,178],{},[147,175,176],{},"Persistence:"," the fear, anxiety, or avoidance is ",[147,179,180],{},"typically present for 6 months or more.",[144,182,183,186],{},[147,184,185],{},"Functional impairment:"," the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.",[144,188,189,192],{},[147,190,191],{},"Not better explained"," by another mental disorder, the effects of a substance or medication, or another medical condition.",[10,194,195,196,199],{},"Clinicians may specify a ",[147,197,198],{},"performance-only"," subtype when the fear is restricted to speaking or performing in public.",[48,201,203],{"id":202},"social-anxiety-vs-related-conditions","Social Anxiety vs Related Conditions",[10,205,206,207,211],{},"Social anxiety overlaps with several conditions but is distinguished by the ",[208,209,210],"em",{},"focus"," of the fear — being negatively evaluated by others:",[141,213,214,220,226,232],{},[144,215,216,219],{},[147,217,218],{},"Panic disorder:"," in panic disorder, panic attacks are unexpected and the central fear is of the attacks themselves and their consequences. In social anxiety, anxiety is cued by anticipated scrutiny, and any panic-like symptoms are tied to fear of embarrassment rather than fear of the sensations alone.",[144,221,222,225],{},[147,223,224],{},"Avoidant personality disorder (AVPD):"," AVPD shares social inhibition and fear of rejection but is more pervasive and trait-like, affecting self-concept across most relationships. The two frequently co-occur; AVPD is generally associated with broader, more chronic impairment.",[144,227,228,231],{},[147,229,230],{},"Autism spectrum conditions:"," social difficulty in autism stems from differences in social communication and interaction rather than primarily from fear of negative evaluation. A person with autism may want fewer social interactions or find them effortful, whereas someone with social anxiety often desires connection but is held back by anxiety. The two can co-occur.",[144,233,234,237],{},[147,235,236],{},"Normal shyness:"," shyness is a common temperament trait. It becomes Social Anxiety Disorder only when the fear is persistent (typically 6 months or more), out of proportion, and causes significant distress or impairment in daily functioning.",[48,239,241],{"id":240},"social-anxiety-assessment-tools","Social Anxiety Assessment Tools",[53,243,244,260],{},[56,245,246],{},[59,247,248,251,254,257],{},[62,249,250],{},"Tool",[62,252,253],{},"Items",[62,255,256],{},"Format",[62,258,259],{},"Typical use",[72,261,262,279,295,312],{},[59,263,264,270,273,276],{},[77,265,266,269],{},[147,267,268],{},"SPIN"," (Social Phobia Inventory)",[77,271,272],{},"17",[77,274,275],{},"Self-report, 0–4 per item, total 0–68",[77,277,278],{},"Brief screening and tracking of fear, avoidance, and physiological symptoms; common screening cutoff ≥19 (Connor et al., 2000).",[59,280,281,286,289,292],{},[77,282,283],{},[147,284,285],{},"Mini-SPIN",[77,287,288],{},"3",[77,290,291],{},"Self-report, 0–4 per item, total 0–12",[77,293,294],{},"Very rapid screening; cutoff ≥6 (Connor et al., 2001).",[59,296,297,303,306,309],{},[77,298,299,302],{},[147,300,301],{},"LSAS"," (Liebowitz Social Anxiety Scale)",[77,304,305],{},"24 situations",[77,307,308],{},"Clinician-administered or self-report; rates fear and avoidance separately",[77,310,311],{},"Detailed assessment and treatment-response measurement (Heimberg et al., 1999).",[59,313,314,320,323,326],{},[77,315,316,319],{},[147,317,318],{},"SPAI"," (Social Phobia and Anxiety Inventory)",[77,321,322],{},"Multi-item (long form and 23-item SPAI-23 short form)",[77,324,325],{},"Self-report",[77,327,328],{},"Broad assessment of somatic, cognitive, and behavioural aspects of social anxiety (original SPAI by Turner & Beidel; SPAI-23 short form evaluated by Schry et al., 2012).",[10,330,331],{},"The SPIN and Mini-SPIN are the briefest, making them well suited to repeat measurement; the LSAS and SPAI provide more granular profiles at the cost of length.",[14,333,335],{"id":334},"anxiety-outcome-monitoring-in-hiboop","Anxiety Outcome Monitoring in HiBoop",[10,337,338],{},"GAD-7, SPIN, LSAS, PHQ-9, and PCL-5, integrated anxiety and comorbid outcome monitoring for outpatient, primary care, and specialty anxiety programs.",{"title":340,"searchDepth":341,"depth":341,"links":342},"",2,[343,344,345,352],{"id":16,"depth":341,"text":17},{"id":29,"depth":341,"text":30},{"id":42,"depth":341,"text":43,"children":346},[347,349,350,351],{"id":50,"depth":348,"text":51},3,{"id":135,"depth":348,"text":136},{"id":202,"depth":348,"text":203},{"id":240,"depth":348,"text":241},{"id":334,"depth":341,"text":335},null,"Anxiety Disorder Screening",[356,359,362],{"text":357,"link":358},"Connor KM, Davidson JR, Churchill LE, Sherwood A, Foa E, Weisler RH. Psychometric properties of the Social Phobia Inventory (SPIN). New self-rating scale. Br J Psychiatry. 2000;176:379-386. PMID: 10827888.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F10827888\u002F",{"text":360,"link":361},"Connor KM, Kobak KA, Churchill LE, Katzelnick D, Davidson JR. Mini-SPIN: A brief screening assessment for generalized social anxiety disorder. Depress Anxiety. 2001;14(2):137-140. PMID: 11668666.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F11668666\u002F",{"text":363,"link":364},"Heimberg RG, Horner KJ, Juster HR, Safren SA, Brown EJ, Schneier FR, Liebowitz MR. Psychometric properties of the Liebowitz Social Anxiety Scale. Psychol Med. 1999;29(1):199-212. PMID: 10077308.","https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F10077308\u002F","SPIN score interpreter (≥19 = SAD screen positive). Social Anxiety Disorder guide covering DSM-5-TR criteria, SPIN vs LSAS comparison, and CBT\u002FSSRI...","md",[368,371,374,377,380],{"question":369,"answer":370},"What is a high SPIN score?","On the Social Phobia Inventory (SPIN), totals range from 0 to 68 across 17 items each rated 0 to 4. Commonly used clinical conventions describe scores of 41 and above as severe and 51 and above as very severe social anxiety. Higher totals reflect more intense fear, avoidance, and physiological symptoms.",{"question":372,"answer":373},"What SPIN score indicates social anxiety?","In the validation study by Connor and colleagues (2000), a SPIN total of 19 distinguished people with social phobia from controls, so 19 is the commonly cited screening cutoff. A score at or above 19 suggests social anxiety symptoms worth a fuller clinical evaluation. It is a screening threshold, not a diagnosis.",{"question":375,"answer":376},"Is the SPIN a diagnostic test?","No. The SPIN is a self-rated screening and symptom-tracking questionnaire, not a diagnostic instrument. A diagnosis of Social Anxiety Disorder requires a clinical evaluation against DSM-5-TR criteria, typically including a structured interview.",{"question":378,"answer":379},"How is the SPIN different from the Mini-SPIN?","The Mini-SPIN is a 3-item short form drawn from the full 17-item SPIN, designed for rapid screening. Connor and colleagues (2001) reported that a Mini-SPIN cutoff of 6 or greater identified generalized social anxiety disorder with about 88.7% sensitivity and 90.0% specificity in a managed care sample.",{"question":381,"answer":382},"What is the difference between the SPIN and the LSAS?","The SPIN is a brief 17-item self-report covering fear, avoidance, and physiological symptoms. The Liebowitz Social Anxiety Scale (LSAS) rates fear and avoidance separately across 24 social and performance situations and exists in clinician-administered and self-report formats, making it more detailed but longer to complete.",false,{"heading":30,"scaleLabel":64,"min":385,"max":386,"start":387,"note":388,"source":389,"bands":390},0,68,19,"17 items, each rated 0–4. Higher totals indicate more severe social anxiety symptoms. A total of ≥19 is the commonly cited screening cutoff for Social Anxiety Disorder.","Connor KM et al. (2000), Br J Psychiatry — the ≥19 screening cutoff is from this validation study. The severity bands below are a commonly used clinical convention, not defined in the original paper. Educational screening reference only — not a diagnosis.",[391,395,398,402,405],{"min":392,"label":126,"level":393,"note":394},51,"error","Very severe social anxiety symptoms. A full clinical evaluation is strongly indicated.",{"min":396,"label":115,"level":393,"note":397},41,"Severe social anxiety symptoms. Clinical evaluation is recommended.",{"min":399,"label":104,"level":400,"note":401},31,"warning","Moderate social anxiety symptoms. Consider discussing results with a clinician.",{"min":403,"label":93,"level":400,"note":404},21,"Mild social anxiety symptoms, above the common ≥19 screening cutoff.",{"min":385,"label":82,"level":406,"note":407},"success","Below the common ≥19 screening cutoff for Social Anxiety Disorder.","2026-06-03",{},true,"\u002Fassessments\u002Fsocial-anxiety-test",{"title":5,"description":365},"social-anxiety-test","assessments\u002Fsocial-anxiety-test","SPIN score interpreter (≥19 = SAD screen positive). 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