Using the Subtle Avoidance Frequency Examination in Adolescent Social Anxiety Assessments

Individuals with social anxiety use safety behaviors to directly or indirectly avoid social situations (e.g., remaining quiet
in a social setting to avoid saying anything embarrassing). Safety behaviors have been hypothesized to prevent the disconfirmation
of feared occurrences while in social situations. Further, research indicates that use of safety behaviors garners negative
reactions from others while in social situations, indicating a link between such behaviors and social skills deficits.

In light of the focus on addressing social skill deficits in current evidence-based treatments for adolescent social anxiety,
we examined whether a measure for assessing safety behaviors in adults [Subtle Avoidance Frequency Examination (SAFE; Cuming
et al. in J Anxiety Disord 23(7):879–883 2009)] could be used reliably and validly in adolescent assessments.

Participants were 40 adolescents (total sample: age range 14–17 years; 14 boys and 26 girls; M = 15.15 years; SD = 0.97) allocated
into age- and gender-matched groups in terms of whether they were (n = 20) or were not (n = 20) clinic referred for a social anxiety assessment.

Results demonstrate that the SAFE (a) has adequate internal consistency; (b) relates positively and uniquely to a widely used
measure of adolescent social anxiety, when considering measures of other distinct psychopathology domains; and (c) differentiates
clinic referred from community control adolescents.

These findings indicate that the SAFE can be reliably and validly administered in adolescent social anxiety assessments and
thus have implications for improvements in treatment monitoring and the study of mechanisms of change for adolescent social
anxiety treatments.