Social Phobia Inventory (SPIN)

 

Article: Psychometric properties of the Social Phobia Inventory

Appropriateness for Dx: This tool is meant for screening of individuals with social phobia and assignment of a severity score (Connor et al., 2000). The tool was created in congruence with DSM-4 but is consistent with the DSM-5 diagnosis of social anxiety disorder, minus some minor changes (Substance Abuse and Mental Health Service Administration [SAMHSA], 2016). Although the study is outdated, Duke University School of Medicine (2020) acknowledges that the tool is still relevant and utilized by their Anxiety and Traumatic Stress Program.

Response to Therapy/Treatment: The SPIN is appropriate for testing treatment response and through studies has proven sensitive to symptom changes over time. Changes in scores are able to determine treatment efficiency (Connor et al., 2000).

Psychometrics: The tool is self-administered and consists of 17 separate statements regarding problems a patient may exhibit if they have social phobia. The statement is then rated on how much it has bothered the individual in the last week, from ‘not at all’ (0) to ‘extremely’ (4). Any score over 21 is considered clinically significant. In the study, the assessment tool was able to effectively separate individuals with and without social phobia. Validity is strong in regard to detecting the severity of illness and is sensitive to symptom reductions during treatment. The scale shows significant correlation with the Liebowitz Social Anxiety Scale Test, The Brief Social Phobia Scale and The Fear Questionnaire social phobia subscale (Connor et al., 2000).

Limitations: Limitations exist in the tool’s alignment with DSM-4 instead of the more recent edition, although differences are very minor (SAMHSA, 2016). With a cutoff score of 19, sensitivity and specificity were good, but some individuals consider the cutoff score to be 15, in which these measures are weaker (Connor et al., 2000).

Sample Solution

presence of renal damage or a decreased functioning rate of glomerular.(GFR<60ml/min/1.73m2) for duration of 90 days or longerwith or without kidney damage.32 The glomerular filtration rate (GFR), which is most commonly estimated (eGFR) using equations that include serum creatinine concentration along with demographic data, is the most frequently used index of overall kidney function.33,34 This condition is frequently not associated with significant symptoms until the disease is far advanced or urinary abnormalities and is unrecognized in 80–90% of cases.35 CKD are at high risk for progress to ESRD, a condition requiring renal replacement therapy, i.e., dialysis or kidney transplantation, to keep the patient’s long-term survival.33,34 The definition of stages 1 and 2 CKD is based upon manifestations of renal damage, i.e., the presence of either micro- or macro-albuminuria, erythrocyturia, or abnormalities on renal ultrasound. Determination of the eGFR in these earlier stages is required only to differentiate between stages 1 and 2 (eGFR >90 or between 60–89 mL min−1 per 1.73 m−2 , respectively). These early stages of CKD are mostly asymptomatic i.e. the normal of kidney functions, but the possibility for advanced disease is significant. As kidney disease worsens, kidney function begins to deteriorate (stages 3 and 4 CKD). Eventually, kidney failure (stage 5 CKD) arises, and kidney replacement therapy is required. Stages 3, 4, and 5 are exclusively defined by GFR (eGFR 30–59, 15–29 or <15 ml min-1 per 1.73 m-2 respectively.)35 The K/DOQI chronic kidney disease staging system (Table 1) is based on GFR.32 Stages of CKD with their GFR values Risk factors for early chronic kidney disease: The following risk factors are associated with a significant (20–40%) risk of CRF: Obesity Hypertension Diabetes mellitus Cigarette smoking Established CVD Age > 60 years

Familial history of stage 5 CKD or hereditary kidney disease in a first or second degree relative

Severe socioeconomic disadvantage.

Presences of renal calculi (6% absolute risk)

Alcohol abuse and Benign prostatic hypertrophy.36

Most common complications and comorbidities of CRF include

Fluid and Electrolyte Abnormalities,

Anaemia,

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