In a therapeutic setting, symptoms of anxiety are assessed and measured on a scale, as one of many tools used to screen for the presence and severity of anxiety.
Typically, a scale is a questionnaire that is administered by a clinician in some cases or by the self in others. Each one lists a series of particular symptoms on a temporal continuum to help assess severity. Those lists focus on general symptoms of anxiety, and others still are designed to help identify and characterize a specific anxiety disorder (e.g., social anxiety).
We now invite you to a review of three well-known anxiety screening tools to help you better understand how you would be evaluated in a therapeutic setting and also to empower you to take charge of your psychological health.
THE STATE-TRAIT ANXIETY INVENTORY (STAI)
Purpose: Measures the presence and severity of current symptoms of anxiety and a generalized propensity to be anxious.
Description: 2 subscales: The State Anxiety Scale (S-Anxiety) evaluates the current state of anxiety, asking how respondents feel “right now.” The Trait Anxiety Scale (T-Anxiety) evaluates relatively stable aspects of “anxiety proneness,” including general states of calmness, confidence, and security.
Format: 40 questions total, 20 for each subscale.
Administration: This is a self-report questionnaire
Score interpretation: Scores for each subtest range from 20 to 80 with high scores indicating greater anxiety. The cut-off point for “clinical” state anxiety (the S-Anxiety scale) is a subject of controversy as some research indicates that 39–40 is high enough while others have suggested 54–55 for older adults.
Sample questions:
S- anxiety scale:
“I feel calm” … NOT AT ALL; SOMEWHAT; MODERATELY SO; VERY MUCH SO
T- anxiety scale:
“ I worry too much over something that really doesn’t matter”……… ALMOST NEVER; SOMETIMES; OFTEN; ALMOST ALWAYS.
BECK ANXIETY INVENTORY (BAI):
Purpose: This measure focuses of on somatic symptoms of anxiety (i.e., physical symptoms).
Format: 21 questions total
Administration: This is a self-report questionnaire
Score interpretation: The total score is calculated by finding the sum of the 21 items. It ranged from 0–63. The following guidelines are recommended for the interpretation of scores: 0–21, low or no anxiety; 22–35, mild to moderate anxiety; and 36 and above, potentially concerning levels of anxiety.
Sample questions:
“Unable to relax”: ………NOT AT ALL; MIDLY BUT IT DIDN’TBOTHER ME MUCH; MODERATELY- IT WASN’T PLEASANT AT TIMES; SEVERLY – IT BOTHERED ME A LOT
“Fear of worst happening”: ………NOT AT ALL; MIDLY BUT IT DIDN’TBOTHER ME MUCH; MODERATELY- IT WASN’T PLEASANT AT TIMES; SEVERLY – IT BOTHERED ME A LOT
HOSPITAL ANXIETY AND DEPRESSION SCALE-ANXIETY (HADS-A)
Purpose: This scale measures generalized symptoms of anxiety and fear. It was specifically created to assess anxiety and depression in medically ill patients.
Description: Two subscales: one focusing on anxiety HADS-A and the other assessing depression HADS-D
Format: 7 questions total
Administration: This is a self-report questionnaire
Score interpretation: Summing the score for each question will yield a total score, keeping in mind that a few items are scored in reverse. The total score for the HADS-A can range from 0 to 21. The following guidelines are recommended for the interpretation of scores: 0–7 for normal or no anxiety, 8–10 for low to mild anxiety, 11–21 for moderate anxiety to severe anxiety.
Sample questions:
I feel tense or ‘wound up’….. MOST OF THE TIME; A LOT OF THE TIME; FROM TIME TO TIME, OCCASIONALLY; NOT AT ALL.
“I get a sort of frightened feeling like’butterflies’ in the stomach:”…….. NOT AT ALL; OCCASIONALLY; QUITE OFTEN; VERY OFTEN.
Reference:
Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11(0 11):S467-72. doi: 10.1002/acr.20561. PMID: 22588767; PMCID: PMC3879951.