Reliability and validity of a structured interview guide for the Hamilton anxiety rating scale (SIGH-A)
Open accessAbstract
The Hamilton Anxiety Rating Scale, a widely used clinical interview assessment tool, lacks instructions for administration and clear anchor points for the assignment of severity ratings. We developed a Structured Interview Guide for the Hamilton Anxiety Scale (SIGH-A) and report on a study comparing this version to the traditional form of this scale. Experienced interviewers from three Anxiety Disorders research sites conducted videotaped interviews using both traditional and structured instruments in 89 participants. A subset of the tapes was co-rated by all raters. Participants completed self-report symptom questionnaires. We observed high inter-rater and test-retest reliability using both formats. The structured format produced similar but consistently higher (+ 4.2) scores. Correlation with a self-report measure of overall anxiety was also high and virtually identical for the two versions. We conclude that in settings where extensive training is not practical, the structured scale is an acceptable alternative to the traditional Hamilton Anxiety instrument.
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The HAM-A showed good reliability between raters and across time, and it correlated well with comparable clinician-rated and self-report measures of depression.
“This commonly used measure has demonstrated good levels of interrater and test-retest reliability, as well as convergent validity with similar clinician rated and self-report measures of depression symptoms (Shear et al., 2001).”
From The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders (2012) · cites this paper as Shear et al., 2001
The Reliability section reports good HAM-A test–retest reliability (ICC 0.86) and interrater reliability (ICC 0.98). The Validity of SIGH-A as a Measure of Hamilton Anxiety Score section reports correlations with the clinician-rated SIGH-A and the self-report Beck Anxiety Inventory, but these measure anxiety, not depression symptoms. (LLM, conf=0.90)
Experimental — accuracy not yet measuredThe Hamilton Anxiety Rating Scale / structured interview guide has good inter-rater and test-retest reliability of ICC = 0.99 and α = 0.86.
“The interview has shown good inter-rater and test-retest reliability of ICC = 0.99, α = 0.86 (Shear et al., 2001).”
From A mobile application for panic disorder and agoraphobia: Insights from a multi-methods feasibility study (2020) · cites this paper as Shear et al., 2001
The Reliability section reports a SIGH-A inter-rater ICC of 0.99 and describes high test-retest reliability. But its SIGH-A test-retest value is ICC = 0.89, not α = 0.86; the 0.86 reported there is the traditional HAM-A’s test-retest ICC. No page number is available in the supplied copy. (LLM, conf=0.91)
Experimental — accuracy not yet measuredThe SIGH-A provides a reliable, valid structured format for administering the Hamilton Anxiety Rating Scale.
“Structured Interview Guide for the Hamilton Anxiety Rating Scale (SIGH-A; Shear et al., 2001) provides a reliable, valid structured format for administering the Hamilton Anxiety Rating Scale (HARS; Hamilton, 1959), a widely used 14-item interviewer administered measure of anxiety.”
From A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder (2013) · cites this paper as Shear et al., 2001
HAMA assessments were conducted by independent evaluators blind to treatment condition, with random selection for interrater reliability.
“Independent evaluators who were blind to treatment condition conducted the HAMA assessments following the Structured Interview Guide for the Hamilton Anxiety Scale (Shear, Vander Bilt, & Rucci, 2001) and assessments were randomly selected throughout the trial to be rated by an additional independent evaluator to ensure interrater reliability (Barlow et al., 2017).”
From Trajectories of change in well-being during cognitive behavioral therapies for anxiety disorders: Quantifying the impact and covariation with improvements in anxiety (2020) · cites this paper as Shear, Vander Bilt, & Rucci, 2001
The HARS has shown good interrater and test-retest reliability and convergent validity with similar clinician-rated and self-report anxiety measures.
“This commonly used measure has demonstrated good levels of interrater and test-retest reliability, as well as convergent validity with similar clinician rated and self-report measures of anxiety symptoms (Shear et al., 2001).”
From Intolerance of Uncertainty: A Common Factor in the Treatment of Emotional Disorders (2013) · cites this paper as Shear et al., 2001
HAM-A is characterized by a high inter-rater reliability and internal consistency (α = 0.85).
“It is characterized by a high inter-rater reliability and internal consistency (α = 0.85; 57).”
The structured interview guide for the Hamilton Anxiety Scale has satisfactory inter-rater and test-retest reliabilities with intraclass correlation coefficients of 0.99 and 0.89, respectively.
“The interview has shown satisfactory inter-rater and test-retest reliabilities of Intraclass Correlation Coefficients of respectively 0.99 and 0.89 [59].”
From Efficacy of a hybrid online training for panic symptoms and agoraphobia: study protocol for a randomized controlled trial. (2014) · cites this paper as [59]
The chosen cut-offs for anxiety and depression indicate significant levels of those conditions.
“The cuts-offs for anxiety and depression indicate significant levels of anxiety and depression3629.”
From Acceptance and Commitment Therapy for Prevention of Chronic Postsurgical Pain and Opioid Use in At-Risk Veterans: A Pilot Randomized Controlled Study. (2018) · cites this paper as [36]
The Methods describe administering anxiety rating scales, and the Discussion describes their use in assessing anxiety severity. Neither section identifies cut-offs indicating significant anxiety or depression; searches for severity thresholds and depression cut-offs found no such passage in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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- Authors
- Shear, M. K., Vander Bilt, J., Rucci, P., Endicott, J., Lydiard, B., Otto, M. W., Pollack, M. H., Chandler, L., Williams, J., Ali, A., & Frank, D. M.
- Affiliations
- University of Pittsburgh (US)
- Columbia University (US)
- Medical University of South Carolina (US)
- Massachusetts General Hospital (US)
- Pfizer (United States) (US)
- Corresponding author
- Shear, M. Katherine
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2001
- Volume
- 13
- Issue
- 4
- Pages
- 166-178
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W1987414908
- Cited by
- 483
- References
- 6
- Citations by year
- 2026: 15 · 2025: 24 · 2024: 28 · 2023: 24 · 2022: 22 · 2021: 29 · 2020: 30 · 2019: 30 · 2018: 45 · 2017: 24 · 2016: 32 · 2015: 25 · 2014: 25 · 2013: 19 · 2012: 21
- FWCI
- 4.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Massachusetts General Hospital
- University of Pittsburgh
- University of South Carolina
- National Institutes of Health (5r24mh053817-05)
- National Institute of Mental Health (MH53817, MH30915)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- Hamilton Anxiety Rating Scale, inter-rater reliability, test-retest reliability, anxiety disorders, interview training
- MeSH terms
- Anxiety Disorders, Humans, Interview, Psychological, Surveys and Questionnaires, Retrospective Studies, Reproducibility of Results, Treatment Outcome
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