What Is the Best Test for Anxiety
Learn how anxiety is diagnosed and what tests can help assess your level of anxiety

Recently, the U.S. Preventive Services Task Force (USPSTF) has recommended screening for anxiety for all adults under age 65 due to the toll on mental health caused by the COVID-19 pandemic.

Screening for anxiety disorders and other mental health problems can help people receive appropriate and timely treatment. Learn how anxiety is diagnosed and what tests can help assess your level of anxiety.

How is anxiety diagnosed?

Your doctor will discuss your symptoms and ask you questions from a lengthy questionnaire. The more specific you can be about what you are going through, the better your doctor will be able to understand your condition.

Based on recognized criteria, an anxiety disorder may be diagnosed if your symptoms interfere with your work performance, school life, or social relationships. 

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition defines anxiety as excessive worry about events or activities for a prolonged period of time in the last 6 months. Anxiety relates to 3 or more of the 6 following symptoms, with at least some symptoms present for more days in the previous 6 months:

  • Restlessness or feeling of being on edge
  • Being easily fatigued
  • Difficulty concentrating 
  • Irritability
  • Muscle tension
  • Sleep disturbance (difficulty falling or staying asleep or restless unsatisfying sleep)

Anxiety, worry, or physical symptoms may produce clinically substantial suffering or impairment in social, occupational, or other key areas of functioning.

What tools are used to test for anxiety in adults?

Self-assessment questionnaires to test for anxiety in adults include the following:

Generalized Anxiety Disorder Assessment (GAD-7)

  • 7-item self-assessment questionnaire that takes up to 1-2 minutes to complete 
  • Designed to assess the severity of generalized anxiety disorder (GAD)
  • Asks the person to assess the intensity of their symptoms in the last 2 weeks. Response options include:
    • Not at all
    • Many days
    • More than half the days
    • Almost every day

Social Phobia Inventory (SPIN)

  • 17-item questionnaire that tests for social anxiety disorder (or social phobia)
  • Scale is based on the previous week's ratings and includes items that measure each of the symptom categories of social anxiety disorder:
    • Fear
    • Avoidance
    • Physiologic arousal
  • Developed because existing self-assessment measures could not capture the whole range of psychological and physiological symptoms, all of which are clinically significant
  • Has strong psychometric qualities and the potential to be a screening and therapy response measure for social phobia

Beck Anxiety Inventory (BAI)

  • 21-item scale that measures the intensity of anxiety symptoms (Beck, Epstein, Brown & Steer, 1988; Beck & Steer, 1993)
  • Asks the respondent to score each item on a 4-point scale ranging from 0-4.
  • Ratings are for the previous week and the items are added up to provide total scores ranging from 0 to 63.

QUESTION

Panic attacks are repeated attacks of fear that can last for several minutes. See Answer

What tools are used to test for anxiety in children and adolescents?

Self-assessment questionnaires to test for anxiety in children and adolescents include the following: 

Wide Test Anxiety Scale

  • 10-item questionnaire that was developed to identify students with anxiety disorders who might benefit from an anxiety-reduction intervention.
  • Takes between 5-8 minutes to complete
  • Has been used for several years by school counselors and has served as the principal test for measuring anxiety

Test Anxiety Inventory for Children and Adolescents (TAICA)

  • Novel multidimensional test anxiety assessment for elementary and secondary school students.
  • 45-item self-report instrument that includes a Total Test Anxiety scale and 4 debilitating test anxiety subscales:
    • Cognitive obstruction or inattention
    • Physiological hyperarousal
    • Social humiliation
    • Worry
  • Includes a facilitating test anxiety scale (performance enhancement or facilitation anxiety) and a lie scale
  • Psychometric features of the scores were investigated in a study with a volunteer sample of 206 children and adolescents

Zung Self-Rating Anxiety Scale (SAS)

  • 20-question self-examination questionnaire that evaluates anxiety levels in subjects presenting with anxiety-related symptoms
  • Focuses on the most prevalent general anxiety disorders; anxiety is commonly associated with stress management
  • Grades each response on a 4-point scale, ranging from never to most of the time

Hamilton Anxiety Rating Scale (HAM-A)

  • One of the first scales to be established to assess the intensity of anxiety symptoms, and it is still often used in clinical and research contexts today.
  • Made up of 14 items, each of which is characterized by a set of symptoms that assesses:
    • Psychic anxiety (mental agitation and psychological discomfort)
    • Somatic anxiety (physical complaints related to anxiety)
  • Extensively used as a clinical trial outcome measure; however, it has been criticized for its inadequate capacity to distinguish between anxiolytic vs. antidepressant effects, as well as somatic anxiety vs. somatic side effects
  • Does not have standardized probing questions on the HAM-A; however, the scale's indicated levels of interrater reliability appear to be satisfactory

What is anxiety vs. anxiety disorder?

Anxiety can cause heart pounding, rapid breathing, stomach flutters, a rush of energy, and a wide range of mental reactions (such as increased concerns, worries or compulsive thinking). 

According to the American Psychiatric Association, anxiety is a natural reaction to stress and can even be advantageous in some situations, such as improving concentration and focus on an exam or project. 

Anxiety disorder, however, is a mental condition that is different from transient feelings of anxiousness or nervousness and more acute feelings of fear or anxiety. Someone with an anxiety disorder may see things as far worse than they are, and their worry impairs their ability to concentrate, sleep, and perform routine tasks.

Anxiety can be the primary symptom of various other disorders, including:

Anxiety disorders often manifest themselves in infancy and early adulthood, and symptoms tend to diminish with age. Some community-based epidemiological studies suggest that people aged 65-79 have the lowest prevalence of anxiety disorders.

What are common types of anxiety disorder?

  • Generalized anxiety disorder: Excessive, uncontrollable concern about everyday matters, such as health, job, or finances
  • Social anxiety disorder: The person may avoid social situations or events due to fear of being embarrassed or rejected
  • Panic disorder: Frequent panic attacks characterized by illogical fear, shortness of breath, dizziness, and other physical symptoms
  • Agoraphobia: The fear of having a panic attack that causes the person to avoid specific circumstances and is often associated with panic disorder
  • Specific phobias: Irrational concerns that are limited to a single object or scenario, such as a fear of animals, insects, locations, or people
  • Claustrophobia: Fear of enclosed spaces or confined environments
  • Obsessive-compulsive disorder: Unwanted thoughts and impulses (obsessions) that cause repetitive, regular behaviors (compulsions) as a coping mechanism for anxiety
  • Post-traumatic stress disorder: Occurs when feelings of anxiety or avoidance persist following a traumatic event and may involve disturbing memories, flashbacks, nightmares, and sleeping difficulties

SLIDESHOW

A Visual Guide to Generalized Anxiety Disorder See Slideshow

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Medically Reviewed on 10/28/2022
References
Image Source: iStock image

DSM-IV to DSM-5 Generalized Anxiety Disorder Comparison. https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t15/

Screening for Anxiety in Adults. https://uspreventiveservicestaskforce.org/uspstf/draft-recommendation/anxiety-adults-screening