The 12-item self-report Questionnaire for Difficulty in Social Communication as a simultaneous prescreening of autism spectrum and social anxiety.

Abstract

Aim: Young patients with social communication difficulties are often diagnosed with autism spectrum disorder (ASD), social communication disorder (SCD), or social anxiety disorder (SAD). This study aimed to develop a questionnaire, especially focusing on the prescreening of SAD complicated by ASD/SCD.

Methods: The 12-item self-report Questionnaire for Difficulty in Social Communication (DISC-12) was developed and analyzed using exploratory factor analysis in 94 patients with ASD/SCD (35 with SAD, 59 without). An additional 17 patients with only SAD were included. Convergent validity was assessed via correlations with the Autism Spectrum Quotient (AQ) and Liebowitz Social Anxiety Scale (LSAS). DISC-12 scores and demographics were compared across ASD/SCD, ASD/SCD + SAD, and SAD groups. Receiver operating characteristic (ROC) analysis of DISC-12 subscales distinguished autistic traits from social anxiety.

Results: Factor analysis revealed a three-factor model for the DISC-12, comprising nonassertiveness, poor empathy, and interpersonal hypersensitivity. DISC-12 showed significant correlations with the AQ (r = 0.412, p < 0.001) and LSAS (r = 0.429, p < 0.001). Patients with ASD/SCD had higher Poor Empathy scores, while SAD patients had higher Interpersonal Hypersensitivity scores than the other groups. ROC analysis indicated that Poor Empathy and Interpersonal Hypersensitivity subscale scores effectively differentiated ASD/SCD from patients with SAD and vice versa.

Conclusion: DISC-12 is a rapid and effective prescreening tool for identifying both ASD and social anxiety, particularly in young patients with self-reported difficulties in social communication.