Fear of offending others in Japan and Canada: A mixed methods evaluation of the Taijin Kyofu Sho questionnaire

Taijin Kyofusho (TKS) has long been considered a Japanese culture-bound social anxiety disorder in the Western literature. One of the defining features of TKS is the fear of offending others, whereas the existing understanding of the "Western" form of social anxiety disorder (SAD) is the fear of embarrassing the self. TKS, however, does not appear to be as culturally specific as previously thought, and has been reported across different cultural contexts. The Taijin Kyofu Sho Questionnaire (TKSQ: Choy et al., 2008) was developed to assess symptoms of TKS in American and Korean patients with SAD. The scale, however, has not yet been validated in Japan nor in other Western cultural contexts. Cognitive processes and contextual factors shaping the experience of completing the TKSQ, as well as the item functioning and cross-cultural equivalence of the TKSQ, need to be examined in a comprehensive research design. This study examined the validity and psychometric properties of a recently developed measure of TKS symptoms, the 30-item Taijin Kyofu Sho Questionnaire (TKSQ: Choy et al., 2008), using a mixed-methods design. The specific objectives were: (1) to evaluate translation errors, questionnaire designs, and unique socio-cultural factors influencing the participants' responses on the TKSQ to better understand TKSQ across cultural contexts; and (2) to evaluate the cross-cultural equivalence of the TKSQ. Cognitive Interviewing (CI), a well-established qualitative method for evaluating survey questions was conducted with Japanese (n = 12) and Euro-Canadian (n = 9) university students with high levels of TKS symptoms. In the quantitative component of the study, two datasets were used to examine the validity of the scale. First, the TKSQ was administered to students in Japan (n = 190) and Canada (n = 78). Differential item functioning (DIF) analyses were conducted to detect items with item bias in TSKQ (Dataset 1). The external validation study was conducted in a separate dataset to examine correlation analysis among TKSQ, TK-S, SIAS, and SCS, also in Japan (n = 124) and Canada (n = 114). Analysis of CI results showed that the major source of error was related to clarity of the scale for the Euro-Canadian sample. Different interpretations of certain items by Japanese participants appeared to be due to translation errors. DIF analysis identified three items demonstrating DIF in Dataset 1, although the TKSQ was positively correlated with TK-S, SIAS, and Interdependent Self-Construal for both groups in Dataset 2. Both CI and quantitative findings have implications for studying cross-cultural differences in TKS-related symptoms and syndromes in Japan and Canada. The novel research design used in this study could strengthen cross-cultural survey development and assessment, providing a more nuanced and integrated view of psychopathological phenomena across cultural contexts.

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