{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T23:01:53Z","timestamp":1782687713958,"version":"3.54.5"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T00:00:00Z","timestamp":1538006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["TR3\u2010119192"],"award-info":[{"award-number":["TR3\u2010119192"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT\u2010148504"],"award-info":[{"award-number":["PJT\u2010148504"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT\u2010149073"],"award-info":[{"award-number":["PJT\u2010149073"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000142","name":"Arthritis Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000142","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004734","name":"Jewish General Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004734","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008582","name":"McGill University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008582","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Systemic sclerosis (<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c) is an autoimmune disease that can cause disfiguring changes in appearance. This study examined the structural validity, internal consistency reliability, convergent validity, and measurement equivalence of the Social Appearance Anxiety Scale (<jats:styled-content style=\"fixed-case\">SAAS<\/jats:styled-content>) across <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c disease subtypes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients enrolled in the Scleroderma Patient\u2010centered Intervention Network Cohort completed the <jats:styled-content style=\"fixed-case\">SAAS<\/jats:styled-content> and measures of appearance\u2010related concerns and psychological distress. Confirmatory factor analysis (<jats:styled-content style=\"fixed-case\">CFA<\/jats:styled-content>) was used to examine the structural validity of the <jats:styled-content style=\"fixed-case\">SAAS<\/jats:styled-content>. Multiple\u2010group <jats:styled-content style=\"fixed-case\">CFA<\/jats:styled-content> was used to determine whether <jats:styled-content style=\"fixed-case\">SAAS<\/jats:styled-content> scores can be compared across patients with limited and diffuse disease subtypes. Cronbach's alpha was used to examine internal consistency reliability. Correlations of <jats:styled-content style=\"fixed-case\">SAAS<\/jats:styled-content> scores with measures of body image dissatisfaction, fear of negative evaluation, social anxiety, and depression were used to examine convergent validity. <jats:styled-content style=\"fixed-case\">SAAS<\/jats:styled-content> scores were hypothesized to be positively associated with all convergent validity measures, with correlations significant and moderate to large in size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 938 patients with <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c were included. <jats:styled-content style=\"fixed-case\">CFA<\/jats:styled-content> supported a 1\u2010factor structure (Comparative Fit Index 0.92, Standardized Root Mean Residual 0.04, and Root Mean Square Error of Approximation 0.08), and multiple\u2010group <jats:styled-content style=\"fixed-case\">CFA<\/jats:styled-content> indicated that the scalar invariance model best fit the data. Internal consistency reliability was good in the total sample (\u03b1 = 0.96) and in disease subgroups. Overall, evidence of convergent validity was found with measures of body image dissatisfaction, fear of negative evaluation, social anxiety, and depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">SAAS<\/jats:styled-content> can be reliably and validly used to assess fear of appearance evaluation in patients with <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c, and <jats:styled-content style=\"fixed-case\">SAAS<\/jats:styled-content> scores can be meaningfully compared across disease subtypes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23514","type":"journal-article","created":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T18:52:39Z","timestamp":1516215159000},"page":"1557-1562","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Validation of the Social Appearance Anxiety Scale in Patients With Systemic Sclerosis: A Scleroderma Patient\u2010Centered Intervention Network Cohort Study"],"prefix":"10.1002","volume":"70","author":[{"given":"Sarah D.","family":"Mills","sequence":"first","affiliation":[{"name":"San Diego State University\/University of California San Diego Joint Doctoral Program in Clinical Psychology San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Kwakkenbos","sequence":"additional","affiliation":[{"name":"McGill University and Jewish General Hospital, Montreal, Quebec, Canada, and Radboud University Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Eve","family":"Carrier","sequence":"additional","affiliation":[{"name":"Jewish General Hospital Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadi","family":"Gholizadeh","sequence":"additional","affiliation":[{"name":"San Diego State University\/University of California San Diego Joint Doctoral Program in Clinical Psychology San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina S.","family":"Fox","sequence":"additional","affiliation":[{"name":"San Diego State University\/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego and Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa R.","family":"Jewett","sequence":"additional","affiliation":[{"name":"McGill University and Jewish General Hospital Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Gottesman","sequence":"additional","affiliation":[{"name":"Scleroderma Foundation Southern California Chapter Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott C.","family":"Roesch","sequence":"additional","affiliation":[{"name":"San Diego State University\/ University of California San Diego Joint Doctoral Program in Clinical Psychology and San Diego State University San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett D.","family":"Thombs","sequence":"additional","affiliation":[{"name":"McGill University and Jewish General Hospital Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa L.","family":"Malcarne","sequence":"additional","affiliation":[{"name":"San Diego State University\/ University of California San Diego Joint Doctoral Program in Clinical Psychology and San Diego State University San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"and the Scleroderma Patient\u2010centered Intervention Network Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,27]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Systemic sclerosis","author":"Clements 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