The Liebowitz Social Anxiety Scale (LSAS)

1. Abstract

The Liebowitz Social Anxiety Scale (LSAS) is widely recognized as the gold standard psychometric instrument for assessing the severity of symptomatology associated with Social Anxiety Disorder (SAD), historically termed social phobia. Developed in 1987 by psychiatrist Michael R. Liebowitz, the instrument was initially conceptualized as a clinician-administered semi-structured rating inventory designed to assess therapeutic change in pharmacological and psychotherapeutic clinical trials. Over the ensuing decades, it has undergone extensive validation both in its original clinician-administered format and as a self-report version (LSAS-SR). The scale comprises 24 distinct social scenarios, each evaluated independently across two parallel dimensions: fear or anxiety (rated on a 4-point Likert-type scale from 0 = none to 3 = severe) and behavioral avoidance (rated on a 4-point Likert-type scale from 0 = never to 3 = usually, representing 67% to 100% of encounters). Consequently, the instrument yields a comprehensive Fear Total score (ranging from 0 to 72), an Avoidance Total score (ranging from 0 to 72), and an overarching Total LSAS score (ranging from 0 to 144).

Subscale decomposition further divides the 24 items into performance situations (13 items, addressing operational scrutiny while completing specific tasks) and social interaction situations (11 items, addressing interpersonal dialogues, initiation of relationships, and peer encounters). Psychometric investigations across diverse clinical, non-clinical, and cross-cultural cohorts consistently confirm outstanding internal consistency, with Cronbach’s alpha coefficients typically exceeding .95 for total scores, and robust test-retest reliability across clinical intervals. Convergent validity is firmly established against concurrent measures including the Social Phobia Scale (SPS), Social Interaction Anxiety Scale (SIAS), and the Fear of Negative Evaluation (FNE) scale, while discriminant validity distinguishes social anxiety from generalized anxiety, major depressive disorder, and panic disorder. Factor-analytic explorations reveal coherent multidimensional structures that capture performance anxiety, public observation, assertive interactions, and informal social engagement. This paper presents an exhaustive academic and psychometric examination of the LSAS, delineating its theoretical architecture, measurement models, diagnostic utility, and contemporary empirical applications.

2. Keywords

Liebowitz Social Anxiety Scale, LSAS, Social Anxiety Disorder, social phobia, psychometrics, fear of negative evaluation, avoidance behavior, performance anxiety, social interaction, clinician-administered rating scale

3. Authors

The scale was conceptualized and authored by:

• Michael R. Liebowitz, M.D.: Professor of Clinical Psychiatry at the Columbia University Vagelos College of Physicians and Surgeons and former Director of the Anxiety Disorders Clinic at the New York State Psychiatric Institute (NYSPI), New York, NY, United States. Dr. Liebowitz is a pioneer in biological psychiatry, psychopharmacology, and affective and anxiety disorders research.

Key academic contributors who led the validation of the self-report version (LSAS-SR) and modern psychometric analyses include:

• Richard G. Heimberg, Ph.D.: Emeritus Professor of Psychology at Temple University and former Director of the Adult Anxiety Clinic of Temple (AACT), Philadelphia, PA, United States.
• David M. Fresco, Ph.D.: Professor of Psychiatry and Research Professor at the Institute for Social Research, University of Michigan, Ann Arbor, MI, United States.
• Murray B. Stein, M.D., M.P.H.: Distinguished Professor of Psychiatry and Family Medicine and Public Health at the University of California San Diego (UCSD), La Jolla, CA, United States.

4. Purpose

The primary purpose of the Liebowitz Social Anxiety Scale is to quantitatively capture the spectrum, intensity, and functional impairment of social anxiety symptomatology. When Dr. Liebowitz constructed the scale in the mid-1980s, social phobia had only recently been recognized as a distinct diagnostic entity within the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III, 1980). At the time, existing clinical psychometric tools failed to differentiate clearly between cognitive-affective subjective distress and behavioral avoidance patterns across varying situational demands. Consequently, the LSAS was engineered to bridge this diagnostic and psychometric void.

In clinical practice, the LSAS serves multiple vital functions:

• Baseline Diagnostic Assessment: It assists clinicians in establishing the baseline severity of social anxiety, delineating whether an individual’s impairment falls into mild, moderate, marked, severe, or very severe categories.
• Subtype Classification: It aids in distinguishing between generalized social anxiety disorder—wherein an individual demonstrates pervasive distress across both social interaction and performance realms—and non-generalized (circumscribed or performance-only) social anxiety, characterized predominantly by anxiety during public speaking or formal operational tasks.
• Treatment Outcome Monitoring: Because the LSAS is highly sensitive to therapeutic change, it is ubiquitous in randomized controlled clinical trials evaluating the efficacy of pharmacotherapies (such as selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and monoamine oxidase inhibitors) and evidence-based psychological interventions (notably Cognitive Behavioral Therapy and exposure therapy protocols).
• Functional Behavioral Mapping: By capturing fear ratings independently from avoidance ratings across identical environmental triggers, the instrument allows therapists to map discrepancies between an individual’s subjective emotional distress and behavioral behavioral coping strategies. For example, some individuals endure excruciating subjective anxiety while maintaining professional responsibilities (high fear, moderate avoidance), whereas others utilize severe avoidance to preemptively eliminate subjective anxiety (moderate fear, extreme avoidance).

In research domains, the LSAS provides an empirical benchmark across neurobiological, behavioral, and epidemiologic investigations. Functional neuroimaging studies investigating amygdala reactivity, insular cortex hyperactivity, and frontostriatal connectivity routinely operationalize continuous symptom severity using LSAS aggregate scores. Epidemiological and cross-cultural studies also utilize the LSAS to determine cross-national prevalence rates, functional disability metrics, and longitudinal developmental trajectories of social anxiety from late adolescence through older adulthood.

5. Psychological Construct

The Liebowitz Social Anxiety Scale measures the multidimensional psychopathological construct of social anxiety, which encompasses affective distress, anticipatory dread, fear of scrutiny, and behavioral withdrawal elicited by anticipated or actual social evaluation. The scale is structured around two orthogonal operational axes: the cognitive-affective symptom dimension (fear/anxiety) and the behavioral motor dimension (avoidance), each manifested across two distinct situational domains: performance situations and social interaction situations.

Fear and Anxiety Dimension

The fear dimension quantifies the subjective, affective, autonomic, and cognitive distress elicited by specific social stimuli. Social anxiety is characterized by heightened physiological arousal (tachycardia, diaphoresis, trembling, blushing, muscle tension) coupled with catastrophic cognitive appraisals regarding public humiliation, negative evaluation, perceived scrutiny, and behavioral incompetence. The LSAS probes the intensity of these experiences on a calibrated spectrum from no fear (absence of subjective distress or autonomic hyperarousal) to severe fear (overwhelming panic-like dread, pervasive autonomic reactivity, and intense desire to escape the context).

Avoidance Dimension

The avoidance dimension assesses the overt behavioral manifestation of negative reinforcement mechanisms. In accordance with Mowrer’s two-factor theory and subsequent cognitive-behavioral paradigms, avoidance behaviors are deployed to prevent or terminate exposure to fear-inducing social stimuli, thereby preventing cognitive disconfirmation of anticipated social catastrophes. The LSAS operationalizes avoidance via explicit frequency metrics: Never (0%), Occasionally (1% to 33% of the time), Often (34% to 66% of the time), and Usually (67% to 100% of the time). This frequency-based operationalization transforms abstract behavioral tendencies into concrete, verifiable behavioral patterns.

Performance Situations

The instrument incorporates 13 performance-oriented items designed to elicit evaluative observation during task execution. In these scenarios, the respondent is typically observed or scrutinized by others while performing a concrete activity or public task. Examples include:

• Item 6: Public speaking (delivering formal remarks to an audience).
• Item 8: Working while being observed (engaging in vocational tasks while supervisors or peers look on).
• Item 9: Writing while being observed (signing checks, completing forms, or typing under observation, which frequently elicits fears of hand tremor or motor awkwardness).
• Item 13: Urinating in a public bathroom (paruresis or shy bladder syndrome, assessing distress regarding autonomic inhibition under perceived physical proximity of others).
• Item 17: Taking a test of your ability, skill, or knowledge (direct formal cognitive or technical evaluation).
• Item 20: Giving a prepared oral talk to a group (formal structured communicative performance).

Social Interaction Situations

The remaining 11 items evaluate bilateral, interpersonal, and communal social encounters where reciprocal communication, self-disclosure, or interpersonal boundary negotiation is required. Unlike performance situations where one is merely observed, social interactions require real-time dialogic processing, social agility, and mutual interpersonal feedback. Examples include:

• Item 2: Participating in a small group activity (collaborative interpersonal exchanges).
• Item 5: Talking to someone in authority (navigating hierarchical social structures, power asymmetries, and potential reprimand).
• Item 7: Going to a party (unstructured social mixing, informal conversational demands).
• Item 11: Talking face to face with someone you don’t know well (spontaneous dyadic interpersonal dialogue).
• Item 18: Expressing disagreement or disapproval to someone you don’t know very well (assertiveness, interpersonal confrontation, and resistance to social compliance).
• Item 21: Speaking to a person with a view to a romantic/sexual relationship (high-stakes interpersonal vulnerability and direct rejection vulnerability).

6. Theoretical Framework

The Liebowitz Social Anxiety Scale is anchored in evolutionary, behavioral, and cognitive models of social anxiety disorder. At its conceptual foundation lies the evolutionary psychology perspective advanced by Michael T. McGuire, Paul Gilbert, and Allan Horwitz, which posits that social anxiety derives from innate agonistic signaling and dominance hierarchy navigation mechanisms. In ancestral mammalian groups, failure to display appropriate deference to dominant conspecifics risked expulsion, physical violence, or ostracism. Consequently, submissive behaviors, social inhibition, and physiological hypervigilance evolved as adaptive protective mechanisms to signal non-hostility and preserve group belonging. In clinical social anxiety, these evolutionary warning systems become hyper-reactive, interpreting benign peer interactions as life-threatening dominance encounters.

Complementing this evolutionary baseline is the cognitive-behavioral model developed by David M. Clark and Adrian Wells (1995), alongside the contemporaneous model by Richard G. Heimberg and colleagues. According to the Clark-Wells model, when individuals with social phobia enter a feared social situation (such as those depicted across the 24 LSAS items), several interconnected pathological processes are activated:

1. Activation of Dysfunctional Assumptions: Core beliefs regarding social inadequacy (“I am inherently flawed,” “If I show anxiety, people will reject me”) generate biased anticipatory appraisals regarding social danger.
2. Shift to Self-Focused Attention: Rather than attending to environmental cues or conversational content, the individual shifts attention inward, creating an internal mental representation of the self as seen by an audience (often visual, somatic, or kinesthetic). Internal sensations of blushing or sweating are taken as definitive proof of conspicuous social catastrophe.
3. Safety-Seeking Behaviors: To avoid catastrophic social rejection, patients enact covert and overt behavioral maneuvers (e.g., rehearsing sentences in advance, gripping glasses tightly to conceal tremors, wearing heavy clothing to mask perspiration, or averting eye contact). Far from protecting the individual, these behaviors exacerbate self-focus, increase somatic distress, and prevent the cognitive processing of disconfirmatory evidence.
4. Post-Event Processing: Following the social event, individuals engage in intense, rumination (“post-event processing” or “the post-mortem”), selectively recalling moments of perceived clumsiness or distress, which reinforces their perceived social deficit.

The LSAS directly operationalizes these theoretical models by simultaneously tracking the subjective cognitive-affective distress (the internal emotional panic and autonomic activation) and the ultimate behavioral consequence (avoidance and safety strategies). By measuring both facets across varied environmental demands, the LSAS captures the exact empirical feedback loop central to cognitive-behavioral psychopathology.

7. Validity

The LSAS exhibits extraordinary construct, concurrent, convergent, discriminant, and predictive validity across diverse empirical investigations spanning four decades.

Convergent and Concurrent Validity

Convergent validity has been repeatedly demonstrated through significant, substantial correlations with alternative validated instruments designed to assess social phobia, fear of negative appraisal, and interpersonal distress. In foundational psychometric evaluations conducted by Heimberg et al. (1999) and Fresco et al. (2001), the LSAS total score demonstrated high correlations with:

• The Social Interaction Anxiety Scale (SIAS): Correlations typically range from r = .70 to r = .83, confirming high congruence regarding interpersonal communication distress.
• The Social Phobia Scale (SPS): Correlations range between r = .68 and r = .81, confirming structural congruence regarding performance scrutiny.
• The Fear of Negative Evaluation Scale (FNE / Brief FNE): Correlations generally range between r = .55 and r = .72, confirming robust alignment with the cognitive hallmark of social phobia.
• The Social Avoidance and Distress Scale (SADS): Correlations between r = .65 and r = .79 substantiate concurrent behavioral and emotional overlap.

Discriminant Validity

The LSAS exhibits exceptional discriminant validity, successfully separating social anxiety from overlapping psychiatric disorders and non-social dimensions of neuroticism. While moderate correlations (r = .30 to .45) are naturally observed with depression inventories—such as the Beck Depression Inventory (BDI-II) and the Patient Health Questionnaire-9 (PHQ-9)—due to comorbidity and generalized negative affect, these correlations are significantly lower than those observed with dedicated social phobia measures. Furthermore, the LSAS correlates weakly to non-significantly (r < .25) with somatic scales measuring generalized medical worries or circumscribed specific phobias (e.g., arachnophobia, blood-injection-injury phobia), confirming that its items measure evaluative threat rather than generic physiological panic.

Diagnostic Sensitivity, Specificity, and Receiver Operating Characteristic (ROC) Metrics

Extensive ROC curve analyses have established clear diagnostic cutoffs for the LSAS. In landmark investigations by Mennin et al. (2002) and Rytwinski et al. (2009), an LSAS total score of 30 was identified as the optimal diagnostic threshold for distinguishing individuals with Social Anxiety Disorder from healthy non-clinical controls, delivering sensitivity rates exceeding 90% and specificity rates above 85%. For identifying the generalized subtype of SAD (as historically codified prior to DSM-5), an LSAS cutoff score of 60 yielded optimal diagnostic balance (sensitivity = 83%, specificity = 86%). Clinical trials frequently utilize baseline scores exceeding 50 or 60 as mandatory inclusion criteria to ensure moderate-to-severe disease severity.

8. Reliability

The psychometric reliability of both the clinician-administered LSAS and the self-report version (LSAS-SR) is exceptionally high, meeting and exceeding standard thresholds for individual diagnostic assessment and clinical trial endpoints.

Internal Consistency

Studies examining the internal consistency of the LSAS have documented remarkable homogeneity among its constituent items:

• Total Score: Across multiple international clinical samples, Cronbach’s alpha coefficients for the overall LSAS score range between α = .94 and α = .96. In non-clinical collegiate and community samples, Fresco et al. (2001) reported an alpha of α = .94.
• Fear Subscale: Internal consistency for the cumulative 24 fear items consistently ranges between α = .91 and α = .94.
• Avoidance Subscale: The cumulative 24 avoidance items demonstrate similarly high internal consistency, with alpha coefficients between α = .89 and α = .93.
• Performance vs. Social Subscales: Alpha coefficients for the individual Performance Fear (α = .82 to .88), Performance Avoidance (α = .78 to .85), Social Fear (α = .85 to .90), and Social Avoidance (α = .81 to .87) subscales remain strong across clinical cohorts.

Test-Retest Reliability and Temporal Stability

The temporal stability of the LSAS has been evaluated across varying test intervals ranging from 1 week to 12 weeks among stable, unmedicated clinical and control participants. Test-retest reliability intraclass correlation coefficients (ICC) and Pearson correlation coefficients consistently indicate high stability:

• Heimberg et al. (1999) reported a 1-to-3 week test-retest correlation of r = .83 for the total score in a clinical social phobia cohort.
• Baker et al. (2002) observed a 12-week test-retest reliability coefficient of r = .79 among waiting-list control subjects, demonstrating that spontaneous score drift in the absence of targeted intervention is minimal.
• The self-report version demonstrates equivalent temporal stability, with test-retest coefficients reported between r = .82 and .87 over a two-week interval (Fresco et al., 2001).

Inter-Rater Reliability

For the clinician-administered format, inter-rater reliability among trained clinical evaluators is exemplary. Video-monitored dual-rating paradigms have demonstrated inter-rater intraclass correlation coefficients exceeding ICC = .90 for the total score, with subscale ICCs ranging between .84 and .93, confirming that standard clinical training protocols yield standardized, reproducible assessments.

9. Factor Analysis

The latent structural organization of the Liebowitz Social Anxiety Scale has been evaluated extensively using both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Although Michael Liebowitz initially proposed a functional two-factor dichotomy based on situational content (Performance vs. Social Interaction), empirical investigations have uncovered richer multidimensional structures.

Empirical Factor Models

In a seminal structural examination, Safren et al. (1999) conducted EFA and CFA on clinical cohorts, revealing that the 24 items of the LSAS are best characterized by a four-factor solution rather than a simple two-factor model:

1. Factor 1: Social Interaction: Encompassing situations requiring dyadic or group reciprocal exchange, such as meeting strangers, calling an unfamiliar person, talking face-to-face, or attending parties (Items 7, 10, 11, 12, 18, 19, 21, 23).
2. Factor 2: Public Speaking / Formal Performance: Comprising formal communicative acts before audiences or authoritative oversight (Items 6, 16, 20).
3. Factor 3: Observation by Others / Informal Performance: Reflecting vulnerability to public surveillance while completing habitual motor tasks, such as eating in public, drinking with others, working while being observed, or writing under observation (Items 1, 3, 4, 8, 9, 13, 14, 15).
4. Factor 4: Assertive Interaction / Conflict: Involving situations requiring interpersonal boundary management, confronting authority figures, or managing interpersonal tension (Items 5, 18, 22, 24).

Model Fit and Higher-Order Structures

Subsequent structural equation modeling across thousands of patients (e.g., Baker et al., 2002; Carleton et al., 2010) validated that while a correlated four-factor or five-factor model achieves superior fit indices compared to a simple unidimensional model, a hierarchical bi-factor model or a second-order general factor model provides the most robust empirical fit:

• Comparative Fit Index (CFI): Ranges between .91 and .95 across clinical structural equation models.
• Tucker-Lewis Index (TLI): Typically exceeds .90.
• Root Mean Square Error of Approximation (RMSEA): Consistently falls between .045 and .062 (90% CI [.041, .067]), indicating acceptable to good model fit.
• Standardized Item Loadings: Standardized factor loadings across all 24 items consistently exceed .50, with core items such as Item 6 (Public Speaking), Item 12 (Meeting Strangers), and Item 15 (Being the center of attention) routinely displaying loadings between .72 and .86.

These findings substantiate the practice of calculating both an overall omnibus score—representing a pervasive general vulnerability to social evaluation—and dedicated subscale scores capturing circumscribed performance versus interaction profiles.

10. Instrument / Measurement Tool

• Instrument Name: Liebowitz Social Anxiety Scale (LSAS) / Liebowitz Social Anxiety Scale – Self-Report (LSAS-SR)
• Author: Michael R. Liebowitz, M.D.
• Year of Development: 1987
• Assessment Type: Clinician-administered semi-structured clinical interview or validated self-report rating scale
• Construct Measured: Severity of social anxiety, public performance anxiety, social evaluative dread, and behavioral avoidance
• Item Count: 24 situational items, each rated across two distinct behavioral axes (total of 48 individual score entries)
• Dual Measurement Structure:
  • Dimension A (Fear or Anxiety Rating):
    • 0 = None (No fear or anxiety in this situation)
    • 1 = Mild (Mild fear or anxiety in this situation)
    • 2 = Moderate (Moderate fear or anxiety in this situation)
    • 3 = Severe (Severe fear or anxiety in this situation)
  • Dimension B (Avoidance Rating):
    • 0 = Never (Never avoid this situation; 0% of encounters)
    • 1 = Occasionally (Occasionally avoid this situation; 1% to 33% of encounters)
    • 2 = Often (Often avoid this situation; 34% to 66% of encounters)
    • 3 = Usually (Usually avoid this situation; 67% to 100% of encounters)
• Administration Time: Clinician-administered format: 15–25 minutes; Self-report format (LSAS-SR): 8–12 minutes
• Scoring Computation:
  • Fear Subtotal: Sum of all 24 ratings in the Fear column (Range: 0–72).
  • Avoidance Subtotal: Sum of all 24 ratings in the Avoidance column (Range: 0–72).
  • Total LSAS Score: Fear Subtotal + Avoidance Subtotal (Range: 0–144).
  • Performance Subscale: Sum of fear and avoidance scores across the 13 performance items (Items 1, 2, 3, 4, 6, 8, 9, 13, 14, 15, 16, 17, 20; Range: 0–78).
  • Social Interaction Subscale: Sum of fear and avoidance scores across the 11 social interaction items (Items 5, 7, 10, 11, 12, 18, 19, 21, 22, 23, 24; Range: 0–66).
• Diagnostic Severity Cutoff Benchmarks:
  • 0 – 29: Non-clinical range / No significant social anxiety
  • 30 – 54: Mild social anxiety (threshold score of 30 suggests potential presence of Social Anxiety Disorder)
  • 55 – 65: Moderate social anxiety
  • 66 – 80: Marked social anxiety (indicates generalized social anxiety patterns)
  • 81 – 95: Severe social anxiety
  • > 95: Very severe social anxiety / Profoundly debilitating social phobia

11. Permissions & Fee and Test Year

The Liebowitz Social Anxiety Scale was first introduced in 1987 by Dr. Michael R. Liebowitz in his landmark book chapter titled “Social Phobia” published in the scientific series Modern Problems of Pharmacopsychiatry (Vol. 22, pp. 141–173). Dr. Liebowitz designed the instrument as a public-domain scientific assessment intended to advance empirical research and therapeutic interventions for an under-recognized psychiatric disorder.

Consequently, the LSAS is non-proprietary and is widely available for clinical, academic, and non-commercial research use without royalty fees. Clinical practitioners, psychiatrists, psychologists, and academic researchers may utilize, reproduce, and administer the scale in research and clinical protocols without requiring explicit licensing fees. However, when administering, publishing findings, or integrating the LSAS into digital applications or research protocols, standard academic citation practices require formal attribution to Dr. Michael R. Liebowitz and the primary psychometric validation studies (Liebowitz, 1987; Heimberg et al., 1999; Fresco et al., 2001). For proprietary commercial distribution within commercial medical software or pharmaceutical enterprise platforms, permission from the copyright holder or Columbia University/NYSPI may be requested depending on institutional policies.

12. References

• Baker, S. L., Heinrichs, N., Kim, H. J., & Hofmann, S. G. (2002). The Liebowitz Social Anxiety Scale as a self-report instrument: A confirmatory factor analysis. Behaviour Research and Therapy, 40(6), 701–715. https://doi.org/10.1016/S0005-7967(01)00060-2
• Carleton, R. N., Collimore, K. C., Asmundson, G. J., McCabe, R. E., Rowa, K., & Antony, M. M. (2010). Refining and validating the Social Interaction Anxiety Scale and the Social Phobia Scale. Depression and Anxiety, 27(1), 71–81. https://doi.org/10.1002/da.20480
• Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69–93). Guilford Press.
• Fresco, D. M., Coles, M. E., Heimberg, R. G., Liebowitz, M. R., Hami, S., Stein, M. B., & Goetz, D. (2001). The Liebowitz Social Anxiety Scale: A comparison of the psychometric properties of self-report and clinician-administered formats. Psychological Medicine, 31(6), 1025–1035. https://doi.org/10.1017/S0033291701004056
• Heimberg, R. G., Horner, K. J., Juster, H. R., Safren, S. A., Brown, E. J., Schneier, F. R., & Liebowitz, M. R. (1999). Psychometric properties of the Liebowitz Social Anxiety Scale. Psychological Medicine, 29(1), 199–212. https://doi.org/10.1017/S0033291798007879
• Liebowitz, M. R. (1987). Social phobia. Modern Problems of Pharmacopsychiatry, 22, 141–173. https://doi.org/10.1159/000414022
• Liebowitz, M., Heimberg, R., Fresco, D., Travers, J., & Stein, M. (2000). Social phobia or social anxiety disorder: What’s in a name? Archives of General Psychiatry, 57(2), 191–192. https://doi.org/10.1001/archpsyc.57.2.191
• Mennin, D. S., Fresco, D. M., Heimberg, R. G., Schneier, F. R., Davies, S. O., & Liebowitz, M. R. (2002). Screening for social anxiety disorder in the clinical setting: Using the Liebowitz Social Anxiety Scale. Journal of Anxiety Disorders, 16(6), 661–673. https://doi.org/10.1016/S0887-6185(02)00134-2
• Rytwinski, N. K., Fresco, D. M., Kangawa, N. E., Collins, K. A., Coles, M. E., Beard, C., & Heimberg, R. G. (2009). Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depression and Anxiety, 26(1), 34–38. https://doi.org/10.1002/da.20503
• Safren, S. A., Turk, C. L., & Heimberg, R. G. (1998). Factor structure of the Liebowitz Social Anxiety Scale for social phobia. Behaviour Research and Therapy, 37(12), 1215–1225. https://doi.org/10.1016/S0005-7967(98)00180-6

13. Items of the Scale (Questionnaire)