Psychiatric Quarterly

, Volume 72, Issue 3, pp 263–276 | Cite as

Assessment of State and Trait Anxiety in Subjects with Anxiety and Depressive Disorders

  • Barbara L. Kennedy
  • John J. Schwab
  • Richard L. Morris
  • Gail Beldia


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.

state trait anxiety depression 


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  1. 1.
    Spielberger C, Gorsuch R, Lushene R: Manual for the State-Trait Anxiety Self-Evaluation Questionnaire. Palo Alto, Calif, Consulting Psychologist Press, 1970.Google Scholar
  2. 2.
    Spielberger C: Manual for the State-Trait Anxiety Inventory. Revised edition. Palo Alto, Calif, Consulting Psychologists Press, 1983.Google Scholar
  3. 3.
    Bieling P, Antony M, Swinson R: The State-Trait Anxiety Inventory, Trait Version: structure and content reexamined. Behaviour Research and Therapy 36:777–788,1998.Google Scholar
  4. 4.
    Greimel ER, Gappmayer-Locker E, Girardi FL, Huber HP: Increasing women's knowledge and satisfaction with cervical cancer screening. Journal of Psychosomatic Obstetrics and Gynaecology 18:273–279, 1997.Google Scholar
  5. 5.
    Gorenstein C, Andrade L: Validation of a Portuguese version of the Beck Depression Inventory and the state-trait anxiety inventory in Brazilian subjects. Brazilian Journal of Medical and Biological Research 29:453–457.Google Scholar
  6. 6.
    Ferguson K, Dacey C: Anxiety, depression, and dissociation in women health care providers reporting a history of childhood psychological abuse. Child Abuse and Neglect21:941–952, 1997.Google Scholar
  7. 7.
    Teichman Y, Shenhar S, Segal S: Emotional distress in Israeli women before and after abortion. American Journal of Orthopsychiatry 63:277–288, 1993.Google Scholar
  8. 8.
    Mondin GW, Morgan WP, Piering PN, Stegner AJ, Stotesbery CL, Trine MR, Wu MY: Psychological consequences of exercise deprivation in habitual exercisers. Medicine and Science in Sports and Exercise 28:1199–1203, 1996.Google Scholar
  9. 9.
    Deane KA, Degner LF: Information needs, uncertainty, and anxiety in women who had a breast biopsy with benign outcome.Cancer Nursing21:117–126, 1998.Google Scholar
  10. 10.
    Allen R, Newman S, Souhami R: Anxiety and depression in adolescent cancer: findings in patients and parents at the time of diagnosis. European Journal of Cancer33:1250–1255, 1997.Google Scholar
  11. 11.
    Addolorato G, Stefanini G, Capristo E, Caputo F, Gasbarrini A, Gasbarrini G: Anxiety and depression in adult untreated celiac subjects and in patients affected by inflammatory bowel disease: a personality “trait” or a reactive illness? Hepatogastroenterology 43:1513–1517, 1996.Google Scholar
  12. 12.
    Addolorato G, Capristo E, Stefanini G, Gasbarrini G: Inflammatory bowel disease: a study of the association between anxiety and depression, physical morbidity, and nutritional status. Scandinavian Journal of Gastroenterology 32:1013–1021, 1997.Google Scholar
  13. 13.
    Crowe J, Runions J, Ebbesen L, Oldridge N, Streiner D: Anxiety and depression after acute myocardial infarct. Heart and Lung 25:98–107, 1996.Google Scholar
  14. 14.
    Kabacoff RI, Segal DL, Hersen M, Van Hasselt VB: Psychometric properties and diagnostic utility of the Beck Anxiety Inventory and the State-Trait Anxiety Inventory with older adult psychiatric outpatients. Journal of Anxiety Disorders 11:33–47, 1997.Google Scholar
  15. 15.
    Shapiro S, Schwartz G, Bonner G: Effects of mindfullness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine 21:581–599, 1998.Google Scholar
  16. 16.
    Oei T, Evans L, Crook G: Utility and validity of the STAI with anxiety disorder patients. British Journal of Clinical Psychology 29:429–432, 1990.Google Scholar
  17. 17.
    Taylor S: The structure of fundamental fears. Journal of Behavior Therapy and Experimental Psychiatry 24:289–299, 1993.Google Scholar
  18. 18.
    Endler NS, Cox BJ, Parker JD, Bagby RM: Self-reports of depression and state-trait anxiety: evidence for differential assessment.Journal of Personality and Social Psychology 63:832–838, 1992.Google Scholar
  19. 19.
    Korobkin S, Herron W, Ramirez S: Severity of symptoms of depression and anxiety as predictors of duration of psychotherapy. Psychological Reports 82: 427–433, 1998.Google Scholar
  20. 20.
    Gottlib I: Depression and general psychopathology in university students. Journal of Abnormal Psychology 93:19–30, 1984.Google Scholar
  21. 21.
    Derogatis L: SCL-90-R: Symptom Checklist-90-R. Minneapolis, Minn, National Computer Systems Inc, 1994.Google Scholar
  22. 22.
    Munjack D, Brown R, McDowell D: Comparison of social anxiety in patients with social phobia and panic disorder. The Journal of Nervous and Mental Disease 175:49–51, 1987.Google Scholar
  23. 23.
    Hamilton M: The assessment of anxiety states by rating. British Journal of Medical Psychology 32:50–55, 1959.Google Scholar
  24. 24.
    Liebowitz MR, Schneier F, Campeas R, et al: Phenelzine vs atenolol in social phobia: a placebo-controlled comparison. Archives of General Psychiatry 49: 290–300, 1992.Google Scholar
  25. 25.
    Versiani M, Nardi A, Mundim F, Alves A, Nick E: Pharmacotherapy of social phobia: a controlled study with moclobemide and phenelzine. British Journal of Psychiatry 161:353–360, 1992.Google Scholar
  26. 26.
    Kobak K, Reynolds W, Greist J: Development and validation of a computeradministered version of the Hamilton Anxiety Scale. Psychological Assessment 5:487–492, 1993.Google Scholar
  27. 27.
    Hamilton M: A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry 23:56–62, 1960.Google Scholar
  28. 28.
    Spitzer RL, Williams S, Gibbon M, Furst MB: Structured Clinical Interview for DSMIII-R. New York, NY, Biometric Research, New York State Psychiatric Institute, 1989.Google Scholar
  29. 29.
    Montgomery-Asberg S, Asberg M: A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134:382–389, 1979.Google Scholar
  30. 30.
    Davidson J, Potts N, Richichi E, Ford S, Krishman N, Smith R, Wilson W: The Brief Social Phobia Scale. Journal of Clinical Psychiatry 52:48–51, 1991.Google Scholar
  31. 31.
    Murphy D, Pickar D, Alterman I: Methods for the quantitative assessment of depression and manic behavior of psychiatric patients. In: Burdock E, Svidilousky A, Greshon S, eds. New York, NY, Marcel Dekker Inc, 1982, pp. 355–392.Google Scholar
  32. 32.
    Goodman W, Price L, Rasmussen S, Mazur C, Fleishmann R, Hill C, Heninger G, Charney D: The Yale-Brown Obsessive Compulsive Scale (YBOCS), part 1: development, use, and reliability. Archives of General Psychiatry 46:1006–1011, 1989.Google Scholar
  33. 33.
    Raskin A, Schulterbrandt J, Reatig N, McKeon J: Differential response to chlorpromazine, imipramine, and placebo. Archives of General Psychiatry 23:164–173, 1970.Google Scholar
  34. 34.
    Lipman R, Covi L: Outpatient treatment of neurotic depression: medication and group psychotherapy. In: Spitzer R, Klein D, eds. Evaluation of the Psychological Therapies. Baltimore, Md, Johns Hopkins University Press, 1976, pp. 178–218.Google Scholar
  35. 35.
    Miller PP, Brown TA, DiNardo PA, Barlow DH: The experimental induction of depersonalization and derealization in panic disordered and nonanxious subjects. Behavior Research Therapy 32:511–519, 1944.Google Scholar
  36. 36.
    Taylor S, Kock WJ, Crockett DJ: Anxiety sensitivity, trait anxiety, and the anxiety disorders. Journal of Anxiety Disorders 5:293–311, 1991.Google Scholar
  37. 37.
    Gurguis GN, Mefford IN, Uhde TW: Hypothalamic-pituitary-adrenocortical activity in panic disorders: relationship to plasma catecholamine metabolites. Biological Psychiatry 30:502–506, 1991.Google Scholar
  38. 38.
    Bruce M, Lader M: DSM-III-R state anxiety symptoms in anxiety disorder patients.Biological Psychiatry 30:519–522, 1991.Google Scholar
  39. 39.
    Hoehn-Saric R, Hazlett RL, McLeod DR: Generalized anxiety disorder with early and late onset of anxiety symptoms. Comprehensive Psychiatry 34:291–298, 1993.Google Scholar
  40. 40.
    Shaffer CS, Shapiro J, Sank LI: Positive changes in depression, anxiety and assertion following individual and group cognitive behavioral therapy intervention. Cognitive Therapy and Research 5:149–157, 1981.Google Scholar
  41. 41.
    Magliozzi JR, Maddock RJ, Gold AS, Gietzen DW: Relationships between thyroid indices and symptoms of anxiety in depressed outpatients. Annals of Clinical Psychiatry 5:111–116, 1993.Google Scholar
  42. 42.
    McKay D, Danyko S, Neziroglu F, Yaryura-Tobias JA: Factor structure of the Yale-Brown Obsessive Compulsive Scale: a two-dimensional measure. Behavior Research 33:865–869, 1995.Google Scholar
  43. 43.
    Creamer M, Foron J, Bell R: The Beck Anxiety Inventory in a nonclinical sample. Behavior Research and Therapy 33:477–485, 1995.Google Scholar
  44. 44.
    Riskin J, Beck A, Brown G, Steer R: Taking the measure of anxiety and depression: validity of the reconstructed Hamilton Scales. Journal of Nervous and Mental Disease 175:474–479, 1987.Google Scholar

Copyright information

© Human Sciences Press, Inc. 2001

Authors and Affiliations

  • Barbara L. Kennedy
    • 1
  • John J. Schwab
    • 1
  • Richard L. Morris
    • 1
  • Gail Beldia
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesUniversity of LouisvilleUSA

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