Structure of the Computer-Assisted Beck Anxiety Inventory With Psychiatric Inpatients

To determine the dimensions of self-reported anxiety in psychiatric inpatients, the Beck Anxiety Inventory (BAI; Beck & Steer, 1990) was administered by computer to 250 inpatients diagnosed with mixed disorders. An iterated principal-factor analysis was performed on the intercorrelations among the 21 BAI items using a Promax rotation. Two factors were found representing somatic and subjective symptoms of anxiety. These dimensions significantly matched those previously described by Beck, Epstein, Brown, and Steer (1988) for outpatients diagnosed with mixed psychiatric disorders. The generalizability of the somatic and subjective dimensions for inpatients and outpatients is discussed.     

Does the Beck Anxiety Inventory measure anything beyond panic attack symptoms?

The Beck Anxiety Inventory (BAI) has become a popular measure in anxiety assessment and the BAI does not overlap in content with measures of depression. There is also some factor analytic evidence to support this distinction. However, an inspection of the BAI's content indicates that many of its items resemble, or are identical to, the symptoms of panic attacks listed in the DSM-IV. Further empirical support for this suspicion is provided from the results of a factor analysis of the BAI items and the individual DSM-IV panic symptoms contained in the Panic Attack Questionnaire, using data from a sample of 157 panic disorder patients. A three-factor model (dizziness related, catastrophic cognitions/fear, cardiorespiratory distress) emerged that replicated a three-factor model of panic symptoms identified in earlier work with another panic disorder sample. All but one of the BAI items loaded highly on the three panic symptom clusters and no separate BAI factor was obtained. The BAI appears to be confounded with, or actually measures, panic attacks rather than anxiety in general. Several implications of this finding are discussed.     

Common and specific dimensions of self-reported anxiety and depression: the BDI-II versus the BDI-IA

The Beck Depression Inventory-II (BDI-II) [Beck, A. T., Steer, R. A. & Brown, G. K. (1996). Manual for Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.] and Anxiety Inventory (BAI) [Beck, A. T. & Steer, R. A. (1993a). Manual for the Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation.] were administered to 840 outpatients who were diagnosed with various types of psychiatric disorders to determine whether the general symptom compositions and relative amounts of variance of the common and specific dimensions of self-reported anxiety and depression for these instruments would be comparable to those that had been found by Steer et al. [Steer, R. A., Clark, D. A., Beck, A. T. & Ranieri, W. F. (1995). Common and specific dimensions of self-reported anxiety and depression: A replication. Journal of Abnormal Psychology, 104, 542–545.] with the BAI and amended Beck Depression Inventory (BDI-IA) [Beck, A. T. & Steer, R. A. (1993b). Manual for the Beck Depression Inventory. San Antonio, TX: Psychological Corporation.]. A Schmid–Leiman transformation was used with the iterated-principal-factor pattern matrix of the BAI and the BDI-II loadings and indicated that the overall symptom compositions and relative amounts of variance that were explained by the one common and two specific anxiety and depression dimensions were comparable to those previously found with the BDI-IA.     

Common and Specific Dimensions of Self-Reported Anxiety and Depression in Adolescent Outpatients

To investigate the common and specific dimensions of anxiety and depression in adolescents, the Beck Anxiety Inventory (BAI; Beck, A. T., & Steer, R. A. Manual for the Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation 1993a) and Beck Depression Inventory-II (BDI-II; Beck, A. T., Steer, R. A., & Brown, G. K. Manual for Beck Depression Inventory (2nd Ed.). San Antonio, TX: Psychological Corporation 1996) were administered to 840 adolescent (13–17 years old) outpatients who were diagnosed with various types of psychiatric disorders. A Schmid-Leiman transformation was used with the iterated-principal-factor pattern matrix of the BAI and the BDI-II loadings. The amounts of orthogonalized common variance that were explained by the one second-order (56%), one first-order depression (22%), and two first-order anxiety (22%) dimensions were comparable to those previously reported for adult psychiatric outpatients. The results were discussed as supporting the construct of negative affectivity that is proposed in L. A. Clark and Watson’s (1991) tripartite model of anxiety and depression.

The Beck Anxiety Inventory-Trait (BAIT): a measure of dispositional anxiety not contaminated by dispositional depression

We describe development of the Beck Anxiety Inventory-Trait (BAIT), a measure of trait anxiety. In Study 1 with 191 undergraduates, the BAIT correlated higher with another trait-anxiety measure than with state anxiety and trait depressiveness and lower with depressiveness than the other trait-anxiety measure did. In Study 2 (Ns of 149 undergraduates initially and 107 at 3 weeks later), the BAIT demonstrated convergent validity against the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) and self-rated trait anxiety plus discriminant validity against abstract curiosity. In Study 3 (Ns of 161 undergraduates initially and 121 at 3 weeks later), the BAIT correlated more highly with another anxiety measure than with depression, stress, positive affect, and negative affect. It also showed good internal consistency across studies and high stability in Studies 2 and 3, higher than the BAI's in Study 2. Factor analyses across studies all supported 2 factors, 1 Somatic and 1 Subjective.     

Types of self-reported anxiety in outpatients with DSM-III-R anxiety disorders1

To ascertain whether psychiatric outpatients can be classified into distinct types according to their self-reported symptoms of anxiety, the Beck Anxiety Inventory (BAI) was administered to 655 outpatients diagnosed with DSM-III-R anxiety disorders. Cluster analysis identified three internally consistent subscales representing subjective, somatic, and panic symptoms. Further analysis revealed six types of outpatients reflecting below average, panic-subjective, low subjective, low somatic-panic, above average, and subjective-somatic anxiety. The types were differentiated with respect to age, primary diagnosis, clinically rated anxiety, and both self-reported and clinically rated depression.     

Ruminative Thoughts and Their Relation to Depression and Anxiety1

Although past research has shown a correlation between ruminative response style and depression (Nolen-Hoeksema, 1991), the basic relationships among amount of ruminative thoughts, depression, and anxiety has not been established. Scores from the Beck Depression Inventory-Second Edition (BDI-II; Beck, Steer, & Brown, 1996), the Beck Anxiety Inventory (BAI; Beck & Steer, 1993), and the McIntosh and Martin (1992) Rumination Scale were analyzed for 199 participants. The correlation between rumination and depression was .33, between rumination and anxiety was .32, and between depression and anxiety was .56. The partial correlation between rumination and depression (controlling for anxiety level) was .20, and the partial correlation between rumination and anxiety (controlling for depression level) was .17. The finding that rumination is not unique to depression but is also associated with the specific negative affect of anxiety alone might also suggest new treatments of these two prevalent disorders.     

The Beck Anxiety Inventory in Older Adults With Generalized Anxiety Disorder

The authors investigated the psychometric properties of the Beck Anxiety Inventory (BAI) in a sample of 75 older generalized anxiety disorder (GAD) patients and a comparison group of 32 older adults without significant psychopathology. Internal consistency was above .80, and the BAI showed evidence of convergent validity in both groups. Evidence for discriminant validity with respect to measures of depression was weaker. Two items, fearing the worst and nervousness, correctly distinguished 86.5% of patients with GAD and 93.8% of the normal controls. Medical comorbidity was associated with somatic but not cognitive anxiety symptoms in the normal older sample. Overall, results indicate the limitations of the BAI in assessing anxiety symptoms in older adults and suggest the need for use of an instrument focusing on cognitive aspects of anxiety.     

Further validation of the IDAS: evidence of convergent, discriminant, criterion, and incremental validity

The authors explicated the validity of the Inventory of Depression and Anxiety Symptoms (IDAS; D. Watson et al., 2007) in 2 samples (306 college students and 605 psychiatric patients). The IDAS scales showed strong convergent validity in relation to parallel interview-based scores on the Clinician Rating version of the IDAS; the mean convergent correlations were .51 and .62 in the student and patient samples, respectively. With the exception of the Well-Being Scale, the scales also consistently demonstrated significant discriminant validity. Furthermore, the scales displayed substantial criterion validity in relation to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) mood and anxiety disorder diagnoses in the patient sample. The authors identified particularly clear and strong associations between (a) major depression and the IDAS General Depression, Dysphoria and Well-Being scales, (b) panic disorder and IDAS Panic, (c) posttraumatic stress disorder and IDAS Traumatic Intrusions, and (d) social phobia and IDAS Social Anxiety. Finally, in logistic regression analyses, the IDAS scales showed significant incremental validity in predicting several DSM-IV diagnoses when compared against the Beck Depression Inventory-II (A. T. Beck, R. A. Steer, & G. K. Brown, 1996) and the Beck Anxiety Inventory (A. T. Beck & R. A. Steer, 1990).     

Anxiety sensitivity within the anxiety disorders: disorder-specific sensitivities and depression comorbidity

The tendency to perceive anxious states as aversive and harmful is hypothesized to confer vulnerability to the development of anxiety disorders. The most commonly used measure of anxiety sensitivity, the Anxiety Sensitivity Index [ASI; Reiss, S., Peterson, R.A., Gursky, D.M., & McNally R.J. (1986). Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behavior Research and Therapy, 24, 1-8], is composed of multiple lower-order factors, assessing fear of physical symptoms, fear of publicly observable anxious symptoms, and fear of cognitive dyscontrol. This study examined the convergent validity of the lower-order anxiety sensitivity dimensions in DSM-IV diagnosed anxiety disorders. Participants with primary diagnoses of panic disorder with agoraphobia, social phobia, and generalized anxiety disorder (GAD) completed the ASI and measures of anxiety and depression severity. Support was found for the convergent validity of all ASI dimensions in reference to thematically related anxiety disorders and in the identification of patients presenting with and without secondary major depressive disorder (MDD). The ASI-fear of cognitive dyscontrol dimension displayed strong and nonredundant associations with GAD, dimensional depression scores, and secondary diagnoses of MDD. The conceptual implications of the shared importance of fear of cognitive dyscontrol in GAD and MDD are discussed.     

Amount of General Factor Saturation in the Beck Anxiety Inventory Responses of Outpatients with Anxiety Disorders

To ascertain the amount of general factor saturation underlying the Beck Anxiety Inventory (BAI; Beck and Steer 1993) responses of anxious patients, the BAI was administered to 525 outpatients with DSM-IV-TR anxiety disorders. McDonald’s omega_hierarchical(ω _h) (Zinbarg et al. 2005) was calculated to estimate the amount of general factor saturation; ω _h is the amount of variance explained by a general (second-order) factor underlying a scale composed of multiple items divided by the total amount of variance explained by all of the scale’s items. An iterated principal-factor analysis was first performed and followed by a Schmid-Leiman transformation to determine the amount of variance explained by the second-order factor. ω _h was 0.70 [95% CI 0.66–0.72], and this value was discussed as supporting the current practice of summing the 21 symptom ratings of the BAI to estimate the overall severity of self-reported anxiety.

Psychometric Meta‐Analysis of the English Version of the Beck Anxiety Inventory

This meta‐analysis reviewed 192 scholarly works from 1993 to 2013 using the Beck Anxiety Inventory (Beck & Steer, 1993 ). Aggregated internal consistency (coefficient alpha) was .91 (k = 117), and test–retest reliability was .65 (k = 18). Convergent comparisons were robust across 33 different anxiety instruments and the Beck Depression Inventory–II (Beck, Steer, & Brown, 1996 ). Structural validity primarily supported the original 2‐factor solution proposed by Beck and Steer ( 1993 ), and diagnostic accuracy varied according to the sample size and criterion cutoff score.     

Psychometric properties of a Spanish version of the Beck Anxiety Inventory (BAI) in general population

This is the first study that provides normative, reliability, factor validity and discriminant validity data of the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) in the Spanish general population, Sanz and Navarro's (2003) Spanish version of the BAI was administered to 249 adults. Factor analyses suggested that the BAI taps a general anxiety dimension comprising two related factors (somatic and affective-cognitive symptoms), but these factors hardly explained any additional variance and, therefore, little information is lost in considering only full-scale scores. Internal consistency estimate for the BAI was high (alpha = .93). The BAI was correlated .63 with the BDI-II and .32 with the Trait-Anger scale of the STAXI 2, but a factor analysis of their items revealed three factors, suggesting that the correlations between the instruments may be better accounted for by relationships between anxiety, depression, and anger, than by problems of discriminant validity. The mean BAI total score and the distribution of BAI scores were similar to those found in other countries. BAI norm scores for the community sample were provided from the total sample and from the male and female subsamples, as females scored higher than males. The utility of these scores for assessing clinical significance of treatment outcomes for anxiety is discussed.     

Homotypic Versus Heterotypic Continuity of Anxiety Symptoms in Young Adolescents: Evidence for Distinctions Between DSM-IV Subtypes

Objective: to investigate homotypic and heterotypic longitudinal patterns of symptoms of separation anxiety disorder (SAD), generalized anxiety disorder (GAD), social phobia (SoPh), panic disorder (PD), and obsessive compulsive disorder (OCD) in young adolescents from the Dutch general population. Method: 2,067 individuals (51.4% girls) from a Dutch community sample, who were assessed for the first time when they were aged 10 to 12 years, were followed up across a period of two years. At both assessments, anxiety symptoms were assessed with the RCADS, a self-report questionnaire. Results: Regression analyses indicated that homotypic continuity was relatively high for SAD, GAD, and SoPh symptoms, and for PD in girls. Conclusions: In many studies, anxiety disorders are treated as one group of disorders, and some widely used assessment instruments, such as the Child Behavior Checklist, do not even contain scales that tap different anxiety dimensions. In the present study, evidence for homotypic continuity was found, especially for symptoms of separation, social, and generalized anxiety, and for symptoms of panic disorder in girls, underscoring the usefulness of making distinctions between different anxiety constructs. An erratum to this article can be found at     

Differential roles of depressive and anxious symptoms and gender in defensiveness

Among a sample of Air Force cadets facing the prospect of basic training (N= 1,190; 1,005 men and 185 women), the influence of a defensive test-taking style on measures of depressive and anxious symptoms was examined. Participants completed the Beck Depression Inventory (Beck & Steer, 1987) and the Beck Anxiety Inventory (Beck, Epstein, Brown, & Steer, 1988), as well as the MMPI (Hathaway & McKinley, 1943) L scale. Results supported hypotheses that defensiveness would affect a self-report measure of depression but not a self-report measure of anxiety and would do so more among men than women. Applied implications of the results are discussed.     

The Beck Anxiety Inventory: Psychometric Properties with Older Adults

The assessment of anxiety disorders in late life is often hindered by the lack of measures specifically validated with older adults. Because anxiety manifestations may vary across age groups, it is important to design new instruments or validate existing measures with older adults. This study examined the psychometric properties of the Beck Anxiety Inventory (BAI) in a sample of 281 older adults who were community-dwelling (82.6%) or living in residential care facilities (17.4%). The mean total BAI score was 6.5 (SD = 7.2), indicating minimal anxiety symptomatology in this older sample. There was a trend for older subjects to score higher. Females scored higher than males, and subjects living in a residential facility scored higher than did community dwellers. Item-total correlations were in the moderate range and the internal consistency of the BAI was adequate (alpha = 0.89). A factor analysis yielded a six-factor structure accounting for 64.6% of the variance, with a somatic factor accounting for the largest portion of the variance (32.2%). Because somatic symptoms are more prevalent with aging, such symptoms should not be weighed as heavily in the total BAI score as cognitive or behavioral symptoms. The findings indicate that the BAI is a useful self-report scale for assessing anxiety symptomatology among older adults.     

Anxiety-Related Stroop Interference in Adolescents

A group of 16- to 18-year-old students was presented with threat-related and neutral Stroop stimuli on separate cards. Participants were assigned to anxiety groups on the basis of their scores on the Beck Anxiety Inventory (BAI; A. T. Beck & R. A. Steer, 1990). It was found, as predicted, that the high-anxiety group took significantly longer to identify the color of the threat-related word than the neutral words, whereas there was no difference for the low-anxiety group. There was a significant linear relationship between interference on the task and BAI scores, showing that as anxiety increases there is a corresponding increase in interference produced by the threat-related stimuli when compared with the neutral stimuli. This study demonstrates an anxiety-related Stroop interference effect for adolescents consistent with that reported in the adult literature.     

Anxiety-related Stroop interference in adolescents

A group of 16- to 18-year-old students was presented with threat-related and neutral Stroop stimuli on separate cards. Participants were assigned to anxiety groups on the basis of their scores on the Beck Anxiety Inventory (BAI; A. T. Beck & R. A. Steer, 1990). It was found, as predicted, that the high-anxiety group took significantly longer to identify the color of the threat-related word than the neutral words, whereas there was no difference for the low-anxiety group. There was a significant linear relationship between interference on the task and BAI scores, showing that as anxiety increases there is a corresponding increase in interference produced by the threat-related stimuli when compared with the neutral stimuli. This study demonstrates an anxiety-related Stroop interference effect for adolescents consistent with that reported in the adult literature.     

The Differential Assessment of State–Trait Anxiety and Depression in a Clinically Anxious Sample

Empirical investigation into anxiety and depression has led some researchers to question the conceptual distinctness of these constructs. N. S. Endler, B. J. Cox, J. D. A. Parker, and R. M. Bagby (1992) provided empirical evidence that state and trait anxiety (using the Endler Multidimensional Anxiety Scales; N. S. Endler, J. M. Edwards, and R. Vitelli, 1991) may be differentiated from depression (using the Beck Depression Inventory; A. T. Beck, 1978) in a student sample. The present study extended this research by employing a different sample, a clinical sample of panic disorder patients (N = 189). Further support for the conceptual distinctness of anxiety and depression is presented herein. The concept of a general distress factor that encompasses both constructs is also discussed.     

Comorbidity and Internet-Delivered Transdiagnostic Cognitive Behavioural Therapy for Anxiety Disorders

Internet-delivered transdiagnostic anxiety interventions aim to reduce symptoms across several anxiety disorders using one treatment protocol. However, it is unclear whether comorbidity affects outcomes of such treatment. This study re-examined data from a recent randomised controlled trial (N = 129) that evaluated the efficacy of an Internet-delivered transdiagnostic cognitive behavioural therapy (iCBT) intervention for participants with principal diagnoses of generalised anxiety disorder (GAD), social phobia (SP) panic disorder and agoraphobia (PDA), of whom 72% met criteria for a comorbid anxiety disorder or depression. Participants were divided into two groups based on whether or not they had a comorbid disorder before treatment. Participants with comorbid conditions reported higher symptom levels at pre-treatment, post-treatment, and follow-up across a range of measures. Both groups showed significant reductions in symptoms over treatment; however, participants with comorbid disorders showed greater reductions in measures of GAD, PDA, SP, depression, and neuroticism. In addition, treatment significantly reduced the number of comorbid diagnoses at follow-up. These results indicate transdiagnostic iCBT protocols have the potential to reduce comorbidity.