# The development and validation of the Offensive-Type Taijin-Kyofu-Sho Scale (OTKSS): A preliminary study using a sample of Japanese University Students

**Authors:** Ryotaro Ishikawa, Naoki Yoshinaga, Satoshi Asakura, Graham Thew, Kana Endo, Takuma Ishigaki, Yuki Nishiguchi, Akira Aoki

PMC · DOI: 10.1371/journal.pmen.0000223 · 2025-05-28

## TL;DR

This study created and tested a new scale to measure offensive-type social anxiety in Japanese university students.

## Contribution

The paper introduces a new self-report scale, the OTKSS, specifically for assessing offensive-type TKS symptoms.

## Key findings

- The OTKSS demonstrated good psychometric properties, including convergent and discriminant validity.
- Test–retest reliability was confirmed over a 4-week interval.
- The scale is reliable and valid for assessing OTKS in Japanese university students.

## Abstract

Taijin-kyofu-sho (TKS) is considered a type of social anxiety disorder. Its subtype, offensive-type TKS (OTKS), is characterized by a fear that one’s own body odor, gaze, facial expressions, and physical defects are socially inappropriate and may cause discomfort to others. Existing self-report measures do not specifically examine the symptoms of OTKS. Therefore, this study aimed to develop a self-report measure for assessing OTKS (Offensive-Type Taijin-Kyofu-Sho Scale: OTKSS). The OTKSS was constructed with four subscales containing seven items each. It was administered to 534 Japanese students who screened positive for social anxiety disorder and reported one or more symptoms of OTKS. The data were subjected to an exploratory factor analysis. Additionally, we conducted a correlation analysis comparing OTKSS with other social anxiety and TKS scales. A second survey examined the test–retest reliability across a 4-week interval with 144 students who screened positive for social anxiety disorder and reported one or more symptoms of OTKS. The results of Survey 1 confirmed the psychometric properties of the OTKSS, including convergent and discriminant validity. Survey 2 confirmed the test–retest reliability. The study indicates that OTKSS is a reliable and valid instrument for assessing OTKS. However, as a limitation, the sample in this study was restricted to Japanese university students. Given that the psychometric work of this paper was conducted only on this population, our findings related to the preliminary evidence of reliability and validity apply to this population only. Future studies using larger sample sizes and clinical samples should test the validity of these measures. In addition, an English version of the scale was simultaneously prepared and will be tested in future studies.

## Linked entities

- **Diseases:** social anxiety disorder (MONDO:0001247)

## Full-text entities

- **Diseases:** OTKS (MESH:C000711528), social anxiety disorder (MESH:D000072861), anxiety (MESH:D001007)

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12798263/full.md

---
Source: https://tomesphere.com/paper/PMC12798263