Kennedy BL, Schwab JJ, Morris RL, Beldia G. Assessment of state and trait anxiety in subjects with anxiety and depressive disorders

Department of Psychiatry and Behavioral Sciences, ACB, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY 40202, USA.
Psychiatric Quarterly (Impact Factor: 1.26). 02/2001; 72(3):263-76. DOI: 10.1023/A:1010305200087
Source: PubMed


The State-Trait Anxiety Inventory (STAI) is one of the most widely used scales for the evaluation of anxiety in medical and, to a lesser extent, psychiatric patients. Although there is a relatively large amount of STAI data about anxiety for individuals with a variety of psychiatric disorders, the results of many anxiety studies include only state or trait and many studies have been influenced by comorbidity and by variations in diagnostic criteria used. We studied state and trait anxiety and compared the revised form of the STAI (Form Y) with the original (Form X) to evaluate the anticipated improvement in the measure. In addition, we compared the STAI results with those of another self-report measure (the Symptom Checklist-90 anxiety and depression scales) and also with interviewer-rated measures of anxiety (Hamilton Rating Scale for Anxiety) and depression (Hamilton Rating Scale for Depression). Results indicate that the STAI does not clearly differentiate anxiety disorders from depressive disorders and support the use of multiple tests and of both self-report and interviewer ratings in the evaluation of anxiety and depression in psychiatric patients.

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    • "al., 2009; Fioravanti et. al., 2006; Kennedy, Schwab, Morris & Beldia, 2001). "
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    ABSTRACT: Resumen Este estudio tuvo como objetivo investigar la estructura interna del State-Trait Anxiety Inventory (STAI-T) en una muestra de deportistas de Brasil. Participaron 179 sujetos que practicaban cinco deportes diferentes, con edades entre 14 y 58 años (M=21,04; DT=4,21). El inventario evalúa la ansiedad como estado y como rasgo, pero en este estudio fue utilizada apenas la escala referente a los rasgos, compuesta por 20 ítems dispuestos en una escala Likert de cuatro puntos. Los resultados del análisis factorial confirmatorio indicaron que los ítems no se ajustaron adecuadamente al modelo originalmente establecido por el instrumento y, considerando ese resultado, se optó por realizar un análisis factorial exploratorio, el cual mostró la existencia de dos factores que explicaron el 33% de la variancia. Esos factores fueron denominados de ansiedad presente y ansiedad ausente, con coeficientes de precisión con valores de 0,82 y 0,72 respectivamente. Palabras clave: STAI-T, evidencia de validez, deportistas, psicología del deporte, evaluación psicológica. Abstract This study aimed to examine the internal structure of the State-Trait Anxiety Inventory (STAI-T) in a sample of Brazilian athletes. Participants were 179 subjects practicing five different sports modalities, aged between 14 and 58 years (M = 21.04; SD = 4.21). The inventory assesses anxiety as state and trait, but in this study only the trait anxiety scale was used which is composed of 20 items arranged in a four-point Likert scale. Results of the confirmatory factor analysis indicated the items were not properly adjusted to the instrument's original model. This exploratory factor analysis indicated the existence of two factors that explained 33% of the variance. These factors were called present anxiety and absent anxiety, with reliability coefficients of 0.82 and 0.72 respectively.
    Acta Colombiana de Psicologia 10/2014; DOI:10.14718/ACP.2014.17.2.13
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    • "Then, despite a correlation between the two scales, the multivariate and multimodal neuroimaging analyses revealed that the anatomical variability in the limbic networks did not contribute to the STAI measurements. The lack of significant findings might dependent upon the fact that STAI scores do not strictly evaluate anxiety per se (Kennedy et al. 2001; Bados et al. 2010), but rather, negative affects and personality traits capturing several dimensions of emotional negativity, including anxiety (Bieling et al. 1998). Personality traits are individual characteristics that influence cognition, emotions, and behavior. "
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    ABSTRACT: Objectives The State-Trait Anxiety Inventory (STAI) and the Hamilton scale for anxiety (HARS) are two of the most important scales employed in clinical and psychological realms for the evaluation of anxiety. Although the reliability and sensibility of these scales are widely demonstrated there is an open debate on what exactly their scores reflect. Neuroimaging provides the potential to validate the quality and reliability of clinical scales through the identification of specific biomarkers. For this reason, we evaluated the neural correlates of these two scales in a large cohort of healthy individuals using structural neuroimaging methods.Case reportNeuroimaging analysis included thickness/volume estimation of cortical and subcortical limbic structures, which were regressed on anxiety inventory scores with age and gender used for assessing discriminant validity. A total of 121 healthy subjects were evaluated. Despite the two anxiety scales, at a behavioral level, displaying significant correlations among them (HARS with STAI-state (r = 0.24; P = 0.006) and HARS with STAI-trait (r = 0.42; P < 0.001)), multivariate neuroimaging analyses demonstrated that anatomical variability in the anterior cingulate cortex was the best predictor of the HARS scores (all β's ≥ 0.31 and P's ≤ 0.01), whereas STAI-related measures did not show any significant relationship with regions of limbic circuits, but their scores were predicted by gender (all β's ≥ 0.23 and P's ≤ 0.02).Conclusion Although the purpose of HARS and STAI is to quantify the degree and characteristics of anxiety-like behaviors, our neuroimaging data indicated that these scales are neurobiologically different, confirming that their scores might reflect different aspects of anxiety: the HARS is more related to subclinical expression of anxiety disorders, whereas the STAI captures sub-dimensions of personality linked to anxiety.
    Brain and Behavior 07/2014; 4(4). DOI:10.1002/brb3.232 · 2.24 Impact Factor
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    • "Our findings are at odds with previous research in college samples that, using only the BDI-II and STAI, found these instruments measure separate depression and anxiety factors, respectively (Alzeghoul et al., 2001; Karagozoglu et al., 2005). However, our findings are consistent with research in nonpsychoeducational samples that found the STAI-Y is not a specific measure of anxiety but instead indexes general distress or negative affect (Andrade et al., 2001; Kennedy et al., 2001; Grös et al., 2007; Bados, Gómez-Benito, & Balaguer, 2010). Endler et al. (1992) found that the EMAS and BDI-II adequately differentiated anxiety and depression while the STAI did not, and he concluded that the STAI is not an effective measure for distinguishing between anxiety and depression . "
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    ABSTRACT: A psychometric evaluation on the measurement of self-report anxiety and depression using the Beck Depression Inventory (BDI-II), State Trait Anxiety Inventory, Form-Y (STAI-Y), and the Per-sonality Assessment Inventory (PAI) was performed using a sample of 534 generally young adults seeking psychoeducational evaluation at a university-based clinic. Confirmatory factor analysis was used to evaluate single-factor and multifactorial models (including hierarchical and higher-order models). Fit indices indicated superiority of the hierarchical model where the BDI-II and PAI depression subscales loaded onto a depression factor, the PAI anxiety subscales loaded onto an anxiety factor, and the STAI-Y State and Trait scale scores loaded onto a separate factor that indexed variance associated with both depression and anxiety. Findings are discussed in regards to the construct validity of the BDI-II, STAI-Y, and PAI in young adults seeking psychoeducational evaluation and relations among these measures.
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