The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders

Maier, Wolfgang; Buller, Raimund; Philipp, Michael; Heuser, Isabella

doi:10.1016/0165-0327(88)90072-9

Cited by 1,044Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingPsychological Testing and Assessment

The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders

Maier, Wolfgang, Buller, Raimund, Philipp, Michael, Heuser, Isabella·1988·Journal of Affective Disorders

DOI 10.1016/0165-0327(88)90072-9

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Abstract

The Hamilton Anxiety Scale (HAM-A) was tested for reliability and validity in two different samples, one sample (n = 97) defined by anxiety disorders, the other sample (n = 101) defined by depressive disorders. The reliability and the concurrent validity of the HAM-A and its subscales proved to be sufficient. Internal validity tested by latent structure analysis was insufficient. The major problems with the HAM-A are that (1) anxiolytic and antidepressant effects cannot be clearly distinguished; (2) the subscale of somatic anxiety is strongly related to somatic side effects. The applicability of the HAM-A in anxiolytic treatment studies is therefore limited. More specific anxiety scales are needed.

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Each HAM-A item is scored on a Likert scale ranging from 0 (not present) to 4 (severe).
“Each item is scored on a Likert scale ranging from 0 (not present) to 4 (severe).”
From The efficacy of virtual reality exposure therapy for the treatment of alcohol use disorder among adult males: a randomized controlled trial comparing with acceptance and commitment therapy and treatment as usual (2023) · cites this paper as [44]
HAM-A total score interpretation: <17 indicates mild severity, 18-24 denotes mild to moderate severity, 25-30 indicates moderate to severe, and >30 indicates severe.
“A total score of <17 indicates mild severity, 18–24 denotes mild to moderate severity, 25–30 indicates moderate to severe, and >30 indicates severe (44).”
From The efficacy of virtual reality exposure therapy for the treatment of alcohol use disorder among adult males: a randomized controlled trial comparing with acceptance and commitment therapy and treatment as usual (2023) · cites this paper as [44]
The HAM-A consists of 14 items which assess 14 anxiety symptoms.
“It consists of 14 items which assess 14 anxiety symptoms.”
From The efficacy of virtual reality exposure therapy for the treatment of alcohol use disorder among adult males: a randomized controlled trial comparing with acceptance and commitment therapy and treatment as usual (2023) · cites this paper as [44]
The Hamilton Anxiety Rating Scale (HAM-A) is an observer-administered instrument to assess the severity of anxiety symptoms.
“The HAM-A is an observer-administered instrument to assess the severity of anxiety symptoms.”
From The efficacy of virtual reality exposure therapy for the treatment of alcohol use disorder among adult males: a randomized controlled trial comparing with acceptance and commitment therapy and treatment as usual (2023) · cites this paper as [44]

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Authors: Maier, W., Buller, R., Philipp, M., & Heuser, I.
Affiliations: Johannes Gutenberg University Mainz (DE)
Corresponding author: Maier, Wolfgang
ORCID: Maier, Wolfgang
Buller, Raimund
Heuser, Isabella
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 1988-01
Volume: 14
Issue: 1
Pages: 61-68
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/0165-0327(88)90072-9
OpenAlex: W2021803359
Cited by: 1,044
References: 15
Citations by year: 2026: 102 · 2025: 132 · 2024: 122 · 2023: 77 · 2022: 81 · 2021: 73 · 2020: 74 · 2019: 56 · 2018: 47 · 2017: 49 · 2016: 45 · 2015: 29 · 2014: 27 · 2013: 22 · 2012: 12
FWCI: 4.75
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Keywords: Hamilton Anxiety Rating Scale, anxiety disorders, depressive disorders, psychometric validation, reliability statistics, concurrent validity, internal validity, latent structure analysis, anxiolytic treatment, antidepressant effects, sensitivity to change
MeSH terms: Agoraphobia, Alprazolam, Amitriptyline, Anxiety Disorders, Clinical Trials as Topic, Depressive Disorder, Humans, Imipramine, Panic, Psychological Tests, Psychometrics, Random Allocation

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The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders

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