The Beck Anxiety Inventory in nonclinical samples: Initial psychometric properties

The Beck Anxiety Inventory (BAI) was recently developed to assess clinical anxiety. Because one of its main features is a focus upon physiological sequelae of anxiety, the inventory may prove useful in nonclinical samples as well. The current paper provides initial psychometric properties with a nonclinical sample. Two studies are presented. The first presents scores and factor structure. A five factor solution was obtained, with one subjective and four somatic factors accounting for approximately 60% of the variance. The second study utilizes the total and factor scores to assess concordance with physiological responding. The total BAI correlated moderately with several physiological domains and with subjective distress. Factor scores were not consistently correlated with corresponding physiological domains. When subjects were divided into high- and low-anxiety groups, the relationships between self-report and physiological response increased in subjects with higher levels of anxiety. Results are discussed in terms of comparing clinical and nonclinical findings, use of the BAI in nonclinical samples, and future research.This research was supported in part by a grant to the first author from the Commission on Academic Excellence, University of Louisville.     

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.     

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.     

Anxiety Symptomatology in Mexican-American Adolescents

Mexican-American adults and adolescents in general have been reported to have high levels of anxiety symptomatology. In our study of a tri-ethnic sample of 2528 junior and senior high school students, the Youth Self Report (YSR) version of the Child Behavior Checklist (CBCL) and a sociodemographic questionnaire was used to assess the anxiety symptoms of Hispanic youth. We compared the ratings on anxiety symptoms, using Achenbach's anxiety subscale on the YSR, between two populations. The anxiety levels of youth in coastal southeast Texas (Galveston County) were compared to the anxiety levels of youth in the lower Rio Grande Valley. We found that Mexican-Americans of the Lower Rio Grande Valley scored higher on anxiety symptoms than the tri-ethnic population of Galveston County. Other factors associated with higher anxiety scores for Mexican-American youths included being born outside the US, linguistic fluency, father absent from the home, mother's education, and household size. Multiple regression analyses showed that socio-economic status (SES), family composition, and linguistic fluency had a greater relative impact on anxiety symptomatology than all other factors, both for the total sample as well as for the Mexican-American sample. These results parallel previous findings, with Mexican-American adults, which suggest either higher risk for anxiety symptomatology or a culturally related bias in the reporting of such symptoms.     

Hassles,anxiety, and negative well-being

Adult volunteers (N = 234) responded to a “decontaminated” hassles scale plus measures of trait anxiety, perceived stress, psychiatric symptomatology, and minor physical ailments. All but the anxiety scale were time-referenced to the past month. Major findings were as follows: (1) Hassles and trait anxiety contributed positively to perceived stress, both individually and interactively, accounting altogether for 55% of the variance; highly anxious subjects showed lower increments in perceived stress with increasing hassles-exposure than did low anxious subjects. (2) Hassles and trait anxiety had a positive synergistic effect on psychiatric symptomatology which, along with the nonsignificant marginal main effects, accounted for 64% of the variance. (3) Hassles and trait anxiety had a positive synergistic effect on minor physical ailments in men; however, highly anxious women, who showed very high levels of illness under even low hassles-exposure, responded less to incremental stress than did low-anxious women. The significant Sex x Hassles x Trait-Anxiety interaction effect and all the implicated lower-order effects jointly accounted for 22% of the variance in minor ailments.     

Generalized anxiety and panic disorders: Response to Cox, Cohen, Direnfeld, and Swinson (1996)

Contrary to the contention of Cox, Cohen, Direnfeld and Swinson (1996, Behaviour Research and Therapy, 34, 949–954) that the Beck Anxiety Inventory (BAI; Beck & Steer, 1993, Manual for the Beck Anxiety Inventory) measures primarily symptoms associated with panic attacks rather than anxiety in general, we propose that the higher level of anxiety found in patients with panic disorders not only is not an artifact of the BAI's symptom content, but patients with panic disorders truly have more anxiety than patients with other types of anxiety disorders. Furthermore, the BAI contains symptoms present in other anxiety disorders, besides panic disorder, and specifically includes 11 symptoms of generalized anxiety disorder (GAD). The BAI and revised Hamilton Anxiety Rating Scale (HARS-R; Riskind, Beck, Brown & Steer, 1987, Journal of Nervous and Mental Disease, 175, 474–479) scores of 274 (69%) outpatients with panic disorders and 123 (31%) outpatients with GAD were found to differentiate these two diagnostic groups equally and significantly. The panic disorder outpatients had higher scores on both the BAI and the HARS-R than did the GAD patients. Thus, Cox et al.'s (1996) speculation about the BAI's yielding spuriously high levels of anxiety in patients with panic disorders revives an important issue relevant to the relation of panic disorder to GAD.     

The Association Between Female College Students' Reports of Depression and Their Perceptions of Parental Attitudes Regarding Gender

This study related female college students' ( n = 377) reports of symptomatology to their reports of parental attitudes suggesting limitations inherent in being female. Young women completed a scale measuring their perceptions that their fathers would have been prouder of them if they were male, and a scale measuring their distress over the limitations experienced by their mothers. Respondents who scored high on either scale exhibited much higher prevalence than other respondents of self-reported depression accompanied by anxiety, somatic symptoms including headaches, insomnia, dyspnea, fatigue, disordered eating, and poor body image/preference for thinness (labeled anxious somatic depression ). Compared to men ( n = 191), women exhibited much higher prevalence of anxious somatic depression, but not higher prevalence of depression unaccompanied by the other symptoms.     

Religiousness on mental health in older adults: the mediating role of social support and healthy behaviours

The positive association between religiousness and mental health among the faithful is well-established; here, social support (SS) and healthy behaviours (HB) are investigated as mechanisms underlying the benefits of faith on depression and anxiety in a survey sample of 97 religious older adults aged 62–96 (M_age?=?79). Initial regression models revealed a significant direct effect (higher religiousness?=?less depression and less anxiety). For depressive symptoms, both individual mediators rendered the effect of religiousness non-significant, with HB explaining more variance (36% vs. 27%); in the combined model, both demonstrated independent, additive effects (SS?=??.18, p?=?.006; HB?=??.34, p?p?=?.005). The results help inform those working with religious older adults facing depression and anxiety by highlighting key aspect(s) of the person’s faith experience that will be most effective in helping to improve his or her mental health.     

Relationships among anxious symptomatology, anxiety sensitivity and laboratory pain responsivity in children

Existing laboratory-based research in adult samples has suggested that anxiety sensitivity (AS) increases an individual's propensity to experience pain-related anxiety, which in turn enhances pain responsivity. Such relationships have not been examined in younger populations. Thus, the present study used structural equation modeling (SEM) to test a conceptual model in which AS would evidence an indirect relationship with pain intensity via its contribution to state-specific anticipatory anxiety in relation to a variety of laboratory pain tasks (cold pressor, thermal heat, and pressure pain) in 234 healthy children (116 girls; mean age = 12.6 years, range = 8-18 years). The model further hypothesized that existing anxious symptomatology would demonstrate a direct relationship with pain intensity. Results of the SEM supported the proposed conceptual model with the total indirect effect of AS accounting for 29% of the variance in laboratory pain intensity via its effects on pain-related anticipatory anxiety. AS did not however, evidence a direct relationship with pain intensity. Anxious symptomatology on the other hand, demonstrated a significant direct effect on pain intensity, accounting for 15% of variance. The combined effects of AS, anxiety symptoms, and anticipatory anxiety together explained 62% of the variance in pain intensity. These relationships did not differ for boys and girls, indicating no moderating effect of sex in the proposed model. The present results support the potential benefit of assessing both AS and anxiety symptoms in children prior to undergoing painful stimulation.     

The Conceptualization of Anxiety: An Exploratory Study of Japanese American Older Adults

Few empirical studies exist on the mental health of Japanese American older adults. This study focused on how Japanese American older adults conceptualize anxiety. Participants were presented with a checklist, which included anxiety and depression symptoms identified in a previous qualitative study conducted by the authors, as well as symptoms from Generalized Anxiety Disorder in the Statistical Manual of Mental Disorders, Fourth Edition (DSM-IVrpar;. They were asked to imagine a Japanese American older adult who was experiencing anxiety and check off the symptoms he/she would be experiencing. Results indicated that these Japanese American participants conceptualized anxiety by using more depressive symptoms than anxiety symptoms. In addition, contrary to previous research and speculation about how Asian Americans experience psychological distress, participants also checked a larger number of cognitive symptoms as opposed to somatic symptoms. The present data suggest that Japanese American older adults conceptualize anxiety differently from the traditional psychiatric conceptualization of anxiety. Thus, clinicians and researchers should not generalize symptoms of psychological distress developed and researched on nonminority older adults to ethnic minority adults, and should consider such ethnic group differences in their assessment and treatment methods for ethnic minority adults.     

Hassles, health, and personality

College undergraduates (N = 211) responded to a "decontaminated" hassles scale plus measures of trait anxiety, reactivity, perceived stress, psychiatric symptomatology, and minor physical ailments. All but the anxiety and reactivity scales were time referenced to the past month. Major findings were as follows: (a) Hassles and trait anxiety both contributed positively to perceived stress, jointly accounting for 58% of the variance; (b) hassles and reactivity both had a significant positive impact on minor ailments, together explaining 23% of the variance; and (c) hassles and trait anxiety had a significant interactive effect on psychiatric symptomatology, which along with the nonsignificant marginal main effects accounted for 67% of the variance. The positive impact of hassles on psychiatric symptomatology increased as trait anxiety rose; likewise, the pathogenic effect of trait anxiety increased with greater exposure to hassles.     

Associations between dimensions of anxiety sensitivity and PTSD symptom clusters in active-duty police officers

Prior studies have shown that anxiety sensitivity (AS) plays an important role in posttraumatic stress disorder (PTSD) symptom severity. The purpose of this study was to evaluate associations between empirically supported PTSD symptom clusters (i.e. reexperiencing, avoidance, numbing, hyperarousal) and AS dimensions (i.e. psychological concerns, social concerns, somatic concerns). Participants were 138 active-duty police officers (70.7% female; mean age = 38.9 years; mean time policing = 173.8 months) who, as a part of a larger study, completed measures of trauma exposure, PTSD symptoms, AS, and depressive symptoms. All participants reported experiencing at least one event that they perceived as traumatic, and 44 (31.9%) screened positive for PTSD. Officers with probable PTSD scored significantly higher on AS total as well as the somatic and psychological concerns dimensional scores than did those without PTSD. As well, a higher percentage of officers with probable PTSD scored positively on the AS-derived Brief Screen for Panic Disorder (Apfeldorf et al., 1994) compared with those without PTSD. A series of regression analyses revealed that depressive symptoms, number of reported traumas, and AS somatic concerns were significant predictors of PTSD total symptom severity as well as severity of reexperiencing. Avoidance was predicted by depressive symptoms and AS somatic concerns. Only depressive symptoms were significantly predictive of numbing and hyperarousal cluster scores. These findings contribute to understanding the nature of association between AS and PTSD symptom clusters. Implications for the treatment of individuals having PTSD with and without panic-related symptomatology are discussed.     

Effectiveness of the Hamilton Anxiety Rating Scale with Older Generalized Anxiety Disorder Patients

To expand the collection of instruments available for assessment of anxiety in the elderly, this report examined the original and revised Hamilton anxiety scales in a sample of 50 older adults diagnosed with Generalized Anxiety Disorder (GAD) and 93 normal community participants (ages 55–82). Although the revised anxiety scale had better discriminant validity (lower correlation with the revised Hamilton depression scale) than the original anxiety and depression scales, a considerable amount of shared variance still existed (41% shared variance, GAD sample alone; 17% control sample alone; 74% shared variance, both samples combined). Near-perfect group classification was possible using 7 items from the original anxiety scale and 10 items from the revised anxiety scale. Results are discussed in light of their implications for use of the Hamilton anxiety rating scale with older anxiety-disordered patients.     

Discrepancies among mother,child, and teacher reports: Examining the contributions of maternal depression and anxiety

The relationship between maternal affective symptomatology and discrepancies in maternal reports of child symptoms, relative to teacher and child reports, was evaluated in a community sample of 188 children ages 9–12 years. Mothers, teachers, and children were administered a structured interview about child psychopathology. In general, mothers reported more child behavior problems than children and teachers, regardless of maternal symptomatology. However, maternal affective symptoms were associated with discrepancies between mothers' and daughters' reports and between mothers' and teachers' reports of girls' externalizing symptoms. Furthermore, mothers who reported high levels of both anxiety and depressive symptomatology tended to report a large number of symptoms that were not confirmed by either their daughters or teachers. Findings are discussed as possible evidence of the role of maternal affective symptomatology in both actual increases in child symptomatology and maternal reporting distortions. Although maternal depressive and anxiety symptoms shared variance in reporting discrepancies, only anxiety explained unique variance. Consistent with previous studies, cross-informant agreement was modest to moderate (r= .16 to .50) and all informants reported more behavior problems in boys than in girls. This work was undertaken with the support of National Institute of Mental Health Grants MH43909 and MH46717.     

Differential relationships of somatic and cognitive anxiety with measures of processing speed in older adults

Research suggests a reciprocal relationship between late-life anxiety and cognition, particularly attention and executive functions. Whereas evidence supports a conceptual distinction between cognitive and somatic dimensions of anxiety, their differential relationship with cognitive outcomes has not been examined, particularly on tests of attention/executive functions that rely on processing speed. Study goals were threefold: (a) to describe levels of overall, cognitive, and somatic anxiety in a sample of older adults without dementia, (b) to determine if overall anxiety is associated with performance on select measures of attention/executive functions that rely on processing speed, and (c) to determine if a differential relationship exists between cognitive and somatic anxiety and cognitive performance. Participants were 368 community-dwelling older adults. Results showed that elevated levels of somatic, but not cognitive anxiety were associated with poorer performance across measures. Findings suggest that the nature of anxiety symptoms may have important implications for cognitive performance in older adults.     

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.     

Trust in God and psychological distress: exploring variations by religious affiliation

Trust in God has been widely identified as a central aspect of religious life, yet relatively few studies have examined whether trust in God is associated with better mental health. This study has two goals. The first is to see if Conservative Christians have greater trust in God than moderate or liberal Christians. The second goal is to see if trusting in God is associated with lower levels of death anxiety, fewer depressed affect symptoms, and fewer somatic symptoms among Conservative Christians than moderate or liberal Christians. The data come from a nationwide survey of middle-aged and older adults (N?=?1535). The findings reveal that, compared to moderate or liberal Christians, trust in God is associated with lower levels of death anxiety as well as fewer symptoms of a depressed affect and lower somatic symptom scores among Conservative Christians.     

Presenting concerns of emerging adults seeking treatment at an early intervention outpatient mood and anxiety program

This study examined presenting concerns and characteristics of emerging adults (EAs) seeking treatment at an early intervention program for mood and anxiety disorders to better understand presenting concerns when treatment is needed. During an intake assessment conducted by a social worker or clinical psychologist, participants (N = 548; 62% female, 38% male) reported their top three current life concerns, which were analyzed qualitatively using thematic analysis. Participants completed a battery of questionnaires assessing demographic information, symptomatology, and daily functioning. Females presented with significantly higher levels of anxiety, and both females and younger individuals (age 16–18) presented with significantly higher levels of depression compared to males and older individuals (age 19–26), respectively. The two most commonly reported presenting concerns were problems in interpersonal relationships and academics, and females were more likely to report academic concerns than males. The majority of participants reported seeking help for a wide range of problems commonly faced by EAs (83.7%), and participants rarely expressed concerns about particular symptoms of mood and/or anxiety disorders (16.3%). EAs and those supporting EAs may benefit from learning when psychosocial concerns are indicative of mental health challenges warranting professional attention.     

Correlates of separation anxiety symptoms among first-semester college students: an exploratory study

Separation anxiety disorder (SAD) is rarely considered in college students with anxious symptomatology, but a growing body of evidence suggests that its symptoms are experienced by a significant number of young adults. The authors examined separation anxiety symptoms in a group of first-semester college students living on campus and experiencing extended separation from significant others, generally for the first time. They examined prevalence of separation anxiety symptoms among college students and the relationship between separation anxiety symptoms and students' educational decisions and performance. Results showed that 21% of first-semester college students reported symptoms of separation anxiety. In addition, separation anxiety symptoms were related to childhood SAD, panic attacks, and educational decisions. Results suggest that SAD may be a valid diagnosis in college students and may impact their educational choices and experiences.