The Liebowitz Social Anxiety Scale: The Complete Guide

A complete guide to The Liebowitz Social Anxiety Scale

In 1987 the Liebowitz Social Anxiety Scale (LSAS) was developed by Michael Liebowitz as an assessment tool for the perceived fear or avoidance of different social situations. Amongst others, the test is widely used as one of the diagnostic tools for social anxiety disorder (SAD). It is used both in scientific research and in therapeutic practice in the context of cognitive-behavioral therapy.

The LSAS consists of 24 items, divided into two subscales. Thirteen questions probe for potential performance anxiety. The other 11 relate to a variety of social situations. 

While it has been historically used by psychiatrists and researchers alike, the Liebowitz Social Anxiety Scale has been validated as a self-report scale

And while you can use it to get a sense of whether social anxiety plays a role in your life across a variety of situations, a clinical diagnosis of this condition would never be made upon the results of this test alone. For a clinical diagnosis, the LSAS would always be supplemented with an interview by a health worker.

Unfortunately, social anxiety disorder is one of the most common mental health disorders. Almost one in 10 individuals in the US suffers from SAD at some point in their life. If you think you may suffer from social phobia, the best way to address the issue is to seek professional help. 

Related: The Best Jobs for People with Social Anxiety Disorder

The LSAS- Instructions

  1. Read each of the proposed situations carefully and answer two questions about each.
    1. The first question asks you to assess the anxiety or fear you felt in that situation
    2. The second question asks how often you avoid the situation
  2. You are asked to rate your responses based on the way the situations have affected you in the last week.
  3. Some of these social situations may not apply to you. In that case, you are asked to imagine being faced with that situation and to rate the fear and avoidance in the same way as above. 

Liebowitz Social Anxiety Scale Scoring

The scale consists of 24 items, which fall into two subcategories– one for performance anxiety and one for anxiety in social situations. For every question, the test-taker is asked to determine the level of fear and level of avoidance on a scale from 0 to 3. Thus, you must answer two questions for every situation that the LSAS describes.

In the context of fear or anxiety, for example, the participants are asked to rate the severity of the felt fear/anxiety from 0 to 3.

Score Severity of Fear/Anxiety
0None
1Mild
2Moderate
3Severe

Similarly, for avoidance questions, test-takers will assess the frequency of avoidance of situations that may have affected them:

Score Frequency of Avoidance
0Never
1Occasionally (1-33% of the time)
2Often (33-67% of the time)
3Usually (67%-100% of the time)

Summing up the scores for both sections of the test, the maximum total score on the Liebowitz Social Anxiety Scale would be 144.

LSAS Meaning and Cut Off Scores

Evidence suggests that an LSAS anxiety score of below 30 indicates that the person is unlikely to suffer from social anxiety disorder.

A score between 30 and 60 suggests that SAD is ‘probable’. A result in this range is often seen by people entering therapy for non-generalized type of SAD. In the non-generalized type of SAD, individuals fear a limited variety of situations, including performance tasks such as being observed while working. Public speaking is a commonly cited example.

For every 10-point increase on the Liebowitz Social Anxiety Scale (LSAS), wages were found to decrease by 1.5 to 2.9% and college graduation to decrease by 1.8%. However, most of these economic costs have not yet been quantified in monetary values

Lipsitz & Schneier, 2000

An LSAS score in the 60-90 range is interpreted as ‘very probable’ social anxiety disorder. Individuals with a score in this range would typically enter treatment for generalized SAD. This type of social anxiety usually involves a fear of most social situations.

Finally, a score of over 90 suggest that SAD is ‘highly probable’. A score in this range would also be typical for individuals with generalized form of social anxiety but often with more severe symptoms such as distress and difficulty in social functioning.

The Test

Here’s what the Liebowitz Social Anxiety Scale questionnaire looks like:

Understanding the SituationsFear/AnxietyAvoidance
1. Using a phone in public
2. Working in small groups
3. Eating in public
4. Drinking with others
5. Talking to someone in authority
6. Acting, performing or giving a talk in front of an audience
7. Going to a party
8. Working while being observed
9. Writing while being observed
10. Calling someone you don’t know very well
11. Talking face to face with someone you don’t know very well
12. Meeting strangers
13. Urinating in a public toilet
14. Entering a room when others are already seated
15. Being the center of attention
16. Speaking up at a meeting
17. Taking a test of your ability, skill or knowledge
18. Expressing disagreement or disapproval to someone you don’t know very well
19. Looking someone who you don’t know very well straight in the eyes
20. Giving a prepared oral talk to a group
21. Trying to make someone’s acquaintance for the purpose of a romantic/sexual relationship
22. Returning goods to a store for a refund
23. Giving a party
24. Resisting a high-pressure salesperson

Validity

The clinical version of the Liebowitz Social Anxiety Scale has been repeatedly found to be highly correlated with other measures of social anxiety (external validity). Moreover, the test has shown remarkable internal consistency.

Read also: The Worst Jobs for People with Social Anxiety

The self-report version of the LSAS (LSAS-SR) has similarly shown high reliability and validity. It has shown good repeatability, internal consistency, it relates constructs that we expect to be related and that should not have a relationship do not. In other words, the LSAS-SR has been shown to do what we expect it to. Further research has also confirmed that the cut-off scores for the clinical version of the LSAS are also applicable to its self-administered version.

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