How severe is your anxiety?
Doctors and therapists use a tool called the Hamilton anxiety rating scale to assist them in ascertaining how serious a patient’s anxiety actually is. In order to measure this anxiety, there is a set of 14 questions which are aimed at the different types of anxiety that patients typically experience. The first thirteen of these questions are answered by the patient based upon interviews and questions asked, whereas the last question is used by the therapists to indicate how they feel the patient is actually doing.
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Max Hamilton developed the HARS test as he felt there was a need to be able to measure both mental and physical or somatic anxiety. Adolescents, children and old people have all been shown to be suitable candidates Hamilton created a list of physical and mental symptoms after using factor analysis to create a list of overall symptoms.
The patient is questioned by a therapist or doctor and his or her answers are then graded from 0-4, with 4 representing the highest level of anxiety. When the test is finished, the doctor or therapist tots up the scores and uses the total to make a determination of the patients anxiety levels. The questions are split into seven for psychic anxieties and seven for somatic anxieties giving the therapist a well rounded look at the patient and making it easier to understand their level of anxiety.
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After adding up the results, it is felt that if a person has a score of less than 17 that this person only has mild anxiety which can be easily treated with therapy. This may not always hold true. Often a patient may be embarrassed by their anxiety problems and try to cover up or hide their true feelings. This is where the skill and training of the therapist or doctor can come into play. Scores from 18-24 show a moderate level of anxiety, this degree of anxiety can be handled by teaching the patient coping techniques such as meditation and breathing exercises. Anything over 25 indicates severe anxiety. When anxiety is this bad there may be a call for the short term use of medication which can be used in conjunction with CBT and other relaxation techniques.
While the test is useful to help therapists to understand a patient’s level of anxiety, it is only as good as the skills of the therapist and the answers are very much subject to interpretation. The questions themselves are designed not only to reflect the answers from the patient but also how the therapist feels about the answers. Although not perfect, the evidence suggests that the test is a reasonably good indicator of a patients anxiety. One area of ambiguity is the tendency for depressed patients to tend to score highly.
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The HARS test is probably the most frequently used test to measure anxiety despite the fact that the results can sometimes be skewed. Over the years it has been shown to provide the most accurate results on a consistent basis. The results from this test are then used with great success to help the patient understand and then overcome their anxieties once and for all.
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