A Japanese Scale to Assess Anxiety Severity: Development and Psychometric Evaluation

Abstract

Objective: This study developed a Japanese self-rating anxiety scale, the Himorogi Self-rating Anxiety Scale (HSAS), and tested psychometric properties of its use in Japanese psychiatric patients. Methods: The process of developing the scale consisted of an intensive literature review, assessment of existing instruments, and detailed discussion on the content of the newly developed scale. Data for psychometric evaluation were collected from 419 outpatients of psychiatric clinics. The Hamilton Rating Scale for Anxiety Interview Guide (HAMA-IG) and the Sheehan Patient Rated Anxiety Scale (SPRAS) were used as standards against which the HSAS was compared. Results: Confirmatory factor analysis revealed a unifactorial nature for the HSAS and fewer insignificant items in the HSAS than the HAMA-IG and the SPRAS. Cronbach's alpha and test-retest coefficients indicated sufficient reliability. High correlation with the HAMA-IG and the SPRAS indicated evidence of convergence for the HSAS. ROC analysis showed high ability to distinguish between the presence and absence or remission of anxiety. Analysis of descriptive data suggested a larger dynamic range for the HSAS than the HAMA-IG and the SPRAS. Conclusions: The HSAS is a brief scale to assess anxiety severity, demonstrating evidence of good psychometric properties. It is recommended for use in research and clinical practice.