The Oxford Agoraphobic Avoidance Scale

Sinead Lambe; Jessica C. Bird; Bao Sheng Loe; Laina Rosebrock; Thomas Kabir; Ariane Petit; Sophie Mulhall; Lucy Jenner; Charlotte Aynsworth; Elizabeth Murphy; Julia Jones; Rosie Powling; Kate Chapman; Robert Dudley; Anthony Morrison; Eileen O. Regan; Ly Mee Yu; David Clark; Felicity Waite; Daniel Freeman

doi:10.1017/S0033291721002713

The Oxford Agoraphobic Avoidance Scale

Sinead Lambe^*, Jessica C. Bird, Bao Sheng Loe, Laina Rosebrock, Thomas Kabir, Ariane Petit, Sophie Mulhall, Lucy Jenner, Charlotte Aynsworth, Elizabeth Murphy, Julia Jones, Rosie Powling, Kate Chapman, Robert Dudley, Anthony Morrison, Eileen O. Regan, Ly Mee Yu, David Clark, Felicity Waite, Daniel Freeman

^*Corresponding author for this work

Psychology

Research output: Contribution to journal › Article › peer-review

Abstract

Background Agoraphobic avoidance of everyday situations is a common feature in many mental health disorders. Avoidance can be due to a variety of fears, including concerns about negative social evaluation, panicking, and harm from others. The result is inactivity and isolation. Behavioural avoidance tasks (BATs) provide an objective assessment of avoidance and in situ anxiety but are challenging to administer and lack standardisation. Our aim was to draw on the principles of BATs to develop a self-report measure of agoraphobia symptoms. Method The scale was developed with 194 patients with agoraphobia in the context of psychosis, 427 individuals in the general population with high levels of agoraphobia, and 1094 individuals with low levels of agoraphobia. Factor analysis, item response theory, and receiver operating characteristic analyses were used. Validity was assessed against a BAT, actigraphy data, and an existing agoraphobia measure. Test-retest reliability was assessed with 264 participants. Results An eight-item questionnaire with avoidance and distress response scales was developed. The avoidance and distress scales each had an excellent model fit and reliably assessed agoraphobic symptoms across the severity spectrum. All items were highly discriminative (avoidance: a = 1.24-5.43; distress: a = 1.60-5.48), indicating that small increases in agoraphobic symptoms led to a high probability of item endorsement. The scale demonstrated good internal reliability, test-retest reliability, and validity. Conclusions The Oxford Agoraphobic Avoidance Scale has excellent psychometric properties. Clinical cut-offs and score ranges are provided. This precise assessment tool may help focus attention on the clinically important problem of agoraphobic avoidance.

Original language	English
Pages (from-to)	1233-1243
Number of pages	11
Journal	Psychological Medicine
Volume	53
Issue number	4
Early online date	23 Aug 2021
DOIs	https://doi.org/10.1017/S0033291721002713
Publication status	Published - 23 Mar 2023

Bibliographical note

Publisher Copyright:
© The Author(s), 2021. Published by Cambridge University Press.

Keywords

agoraphobic avoidance
Assessment
psychosis
social withdrawal

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10.1017/S0033291721002713Licence: CC BY

The Oxford Agoraphobic Avoidance Scale
© The Author(s), 2021
Final published version, 746 KBLicence: CC BY

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Lambe, S., Bird, J. C., Loe, B. S., Rosebrock, L., Kabir, T., Petit, A., Mulhall, S., Jenner, L., Aynsworth, C., Murphy, E., Jones, J., Powling, R., Chapman, K., Dudley, R., Morrison, A., Regan, E. O., Yu, L. M., Clark, D., Waite, F., & Freeman, D. (2023). The Oxford Agoraphobic Avoidance Scale. Psychological Medicine, 53(4), 1233-1243. https://doi.org/10.1017/S0033291721002713

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abstract = "Background Agoraphobic avoidance of everyday situations is a common feature in many mental health disorders. Avoidance can be due to a variety of fears, including concerns about negative social evaluation, panicking, and harm from others. The result is inactivity and isolation. Behavioural avoidance tasks (BATs) provide an objective assessment of avoidance and in situ anxiety but are challenging to administer and lack standardisation. Our aim was to draw on the principles of BATs to develop a self-report measure of agoraphobia symptoms. Method The scale was developed with 194 patients with agoraphobia in the context of psychosis, 427 individuals in the general population with high levels of agoraphobia, and 1094 individuals with low levels of agoraphobia. Factor analysis, item response theory, and receiver operating characteristic analyses were used. Validity was assessed against a BAT, actigraphy data, and an existing agoraphobia measure. Test-retest reliability was assessed with 264 participants. Results An eight-item questionnaire with avoidance and distress response scales was developed. The avoidance and distress scales each had an excellent model fit and reliably assessed agoraphobic symptoms across the severity spectrum. All items were highly discriminative (avoidance: a = 1.24-5.43; distress: a = 1.60-5.48), indicating that small increases in agoraphobic symptoms led to a high probability of item endorsement. The scale demonstrated good internal reliability, test-retest reliability, and validity. Conclusions The Oxford Agoraphobic Avoidance Scale has excellent psychometric properties. Clinical cut-offs and score ranges are provided. This precise assessment tool may help focus attention on the clinically important problem of agoraphobic avoidance.",

keywords = "agoraphobic avoidance, Assessment, psychosis, social withdrawal",

author = "Sinead Lambe and Bird, {Jessica C.} and Loe, {Bao Sheng} and Laina Rosebrock and Thomas Kabir and Ariane Petit and Sophie Mulhall and Lucy Jenner and Charlotte Aynsworth and Elizabeth Murphy and Julia Jones and Rosie Powling and Kate Chapman and Robert Dudley and Anthony Morrison and Regan, {Eileen O.} and Yu, {Ly Mee} and David Clark and Felicity Waite and Daniel Freeman",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2021. Published by Cambridge University Press.",

year = "2023",

month = mar,

day = "23",

doi = "10.1017/S0033291721002713",

language = "English",

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T1 - The Oxford Agoraphobic Avoidance Scale

AU - Lambe, Sinead

AU - Bird, Jessica C.

AU - Loe, Bao Sheng

AU - Rosebrock, Laina

AU - Kabir, Thomas

AU - Petit, Ariane

AU - Mulhall, Sophie

AU - Jenner, Lucy

AU - Aynsworth, Charlotte

AU - Murphy, Elizabeth

AU - Jones, Julia

AU - Powling, Rosie

AU - Chapman, Kate

AU - Dudley, Robert

AU - Morrison, Anthony

AU - Regan, Eileen O.

AU - Yu, Ly Mee

AU - Clark, David

AU - Waite, Felicity

AU - Freeman, Daniel

PY - 2023/3/23

Y1 - 2023/3/23

N2 - Background Agoraphobic avoidance of everyday situations is a common feature in many mental health disorders. Avoidance can be due to a variety of fears, including concerns about negative social evaluation, panicking, and harm from others. The result is inactivity and isolation. Behavioural avoidance tasks (BATs) provide an objective assessment of avoidance and in situ anxiety but are challenging to administer and lack standardisation. Our aim was to draw on the principles of BATs to develop a self-report measure of agoraphobia symptoms. Method The scale was developed with 194 patients with agoraphobia in the context of psychosis, 427 individuals in the general population with high levels of agoraphobia, and 1094 individuals with low levels of agoraphobia. Factor analysis, item response theory, and receiver operating characteristic analyses were used. Validity was assessed against a BAT, actigraphy data, and an existing agoraphobia measure. Test-retest reliability was assessed with 264 participants. Results An eight-item questionnaire with avoidance and distress response scales was developed. The avoidance and distress scales each had an excellent model fit and reliably assessed agoraphobic symptoms across the severity spectrum. All items were highly discriminative (avoidance: a = 1.24-5.43; distress: a = 1.60-5.48), indicating that small increases in agoraphobic symptoms led to a high probability of item endorsement. The scale demonstrated good internal reliability, test-retest reliability, and validity. Conclusions The Oxford Agoraphobic Avoidance Scale has excellent psychometric properties. Clinical cut-offs and score ranges are provided. This precise assessment tool may help focus attention on the clinically important problem of agoraphobic avoidance.

AB - Background Agoraphobic avoidance of everyday situations is a common feature in many mental health disorders. Avoidance can be due to a variety of fears, including concerns about negative social evaluation, panicking, and harm from others. The result is inactivity and isolation. Behavioural avoidance tasks (BATs) provide an objective assessment of avoidance and in situ anxiety but are challenging to administer and lack standardisation. Our aim was to draw on the principles of BATs to develop a self-report measure of agoraphobia symptoms. Method The scale was developed with 194 patients with agoraphobia in the context of psychosis, 427 individuals in the general population with high levels of agoraphobia, and 1094 individuals with low levels of agoraphobia. Factor analysis, item response theory, and receiver operating characteristic analyses were used. Validity was assessed against a BAT, actigraphy data, and an existing agoraphobia measure. Test-retest reliability was assessed with 264 participants. Results An eight-item questionnaire with avoidance and distress response scales was developed. The avoidance and distress scales each had an excellent model fit and reliably assessed agoraphobic symptoms across the severity spectrum. All items were highly discriminative (avoidance: a = 1.24-5.43; distress: a = 1.60-5.48), indicating that small increases in agoraphobic symptoms led to a high probability of item endorsement. The scale demonstrated good internal reliability, test-retest reliability, and validity. Conclusions The Oxford Agoraphobic Avoidance Scale has excellent psychometric properties. Clinical cut-offs and score ranges are provided. This precise assessment tool may help focus attention on the clinically important problem of agoraphobic avoidance.

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KW - Assessment

KW - psychosis

KW - social withdrawal

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SN - 0033-2917

VL - 53

SP - 1233

EP - 1243

JO - Psychological Medicine

JF - Psychological Medicine

IS - 4

ER -

The Oxford Agoraphobic Avoidance Scale

Abstract

Bibliographical note

Keywords

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