Methods and instruments for assessing anxiety

Anxiety assessment is a multifaceted process that uses a variety of methods and instruments to gain a comprehensive understanding of an individual’s anxious experience.

These include clinical interviews, standardized questionnaires, and self-report tools.

The Clinical Interview

The clinical interview is a fundamental tool in assessment.

It allows the practitioner to gather detailed information about the history of the anxiety problem, the specific symptoms, their frequency, intensity, and duration, triggering and maintaining factors, the impact on daily functioning, and the presence of other mental or physical health problems.

Through the interview, the clinician can also observe the patient’s nonverbal behavior and establish a therapeutic relationship.

Interviews may be unstructured, semi-structured, or structured (following a specific set of questions, such as those designed for DSM diagnosis).

Questionnaires and Standardized Scales

There are numerous standardized questionnaires and scales designed to measure different aspects of anxiety and specific disorders.

These instruments are usually self- or clinician-administered and provide quantitative scores that can be compared to population norms or used to measure change over time.

Some common examples include:

• General Anxiety Scales: Such as the Beck Anxiety Inventory (BAI) or the Hamilton Anxiety Rating Scale (HARS).

• Disorder-Specific Scales: Such as the Agoraphobia Inventory, the Liebowitz Social Anxiety Scale (LSAS), or the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).

• Worry Questionnaires: Such as the Pennsylvania State Worry Questionnaire (PSWQ).

These instruments help to objectify the assessment and complement the information obtained in the interview.

Self-Records as a Monitoring Tool

Self-records are a very valuable tool that involves the person systematically recording their experiences of anxiety in daily life, usually between therapy sessions.

You are asked to write down information such as:

• Situation: Where and when did the anxiety occur?

• Thoughts: What thoughts went through your mind before,during and after?

• Emotions: What emotions did you feel and how intensely?

• Physical Sensations: What physical symptoms did you experience?

• Behaviors: What did you do in response to the anxiety (e.g., avoidance, safety behaviors)?

Self-records help both the person and the therapist identify patterns, triggers, and maintaining factors of the anxiety.

They encourage self-awareness and provide concrete information to guide treatment, such as identifying thoughts to reframe or situations for exposure.

They are a form of "homework" that actively engages the person in their therapeutic process.