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

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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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“PD-MCI (N = 13) PD-NC (N = 24) Non-PD (N = 20) p-value Post-hoc analysis Sex (M/F)a 8/4 13/11 12/9 ns Age (years)c 70.38 (8.61, 54–83) 67.75 (9.29, 52–83) 64.00(8.08, 50–77) ns Education (years)b 12.31 (3.54, 6–16) 13.22 (3.67, 6–18) 14.66(3.36, 10–20) ns Disease Duration (Year)d 6.00 (3.70, 0–13) 4.29 (3.38, 0–12) ns…”
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Du, Y., Hua, L., Tian, S., Dai, Z., Xia, Y., Zhao, S., Zou, H., Wang, X., Sun, H., Zhou, H., et al. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.06.001 · Cited by 25
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“Furthermore, this clinician‐based questionnaire is also available in the public domain, where it has been employed as a self‐scored survey.(19) The HAMA consists of 14 symptom‐defined elements, which include both psychological and somatic symptoms: anxious mood, tension (including startle response, fatigability, and r…”
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“Severity of anxiety symptoms before the pandemic was assessed with the Hamilton Anxiety Rating Scale (HAM-A; [42]), a clinician-based questionnaire consisting of 14 items with sufficient internal reliability [43].”
Method
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“B Montreal Cognitive Assessment‑Basic ACE‑III Addenbrooke’s Cognitive Examination III BNT Boston Naming Test AFT Animal Verbal Fluency Test STT Shape Trail Test SDMT Symbol Digit Modalities Test DST Digit Span Test JLO Judgment of Line Orientation ECog Everyday Cognition PSQI Pittsburgh Sleep Quality Index TUGT Timed…”
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“Additionally, we evaluated anxiety, depression, and cognitive function of all the participants by using the Hamilton Anxiety Scale (HAMA) [28], the Hamilton Depression Scale (HAMD) [29], and the Montreal Cognitive Assessment (MoCA) Beijing Version (www.mocatest.org).”
MethodInfluential
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“At the MRI visit, a psychiatrist completed the Young Mania Rating Scale (YMRS; Young et al., 1978) and Hamilton Depression and Anxiety Rating Scales (HAM-D & HAM-A, respectively; Hamilton, 1967; Maier et al., 1988) with participants with BD, and the Global Assessment of Functioning (GAF) with all participants (Table 2…”
Method
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“1990), and subjects were assessed using the Hamilton Anxiety Rating Scale (Maier et al. 1998) at the start of the study and then again at weeks 4, 12 and 26 of treatment. The study group (n = 54) received, in addition to benzodiazepines/supportive psychotherapy/and simple relaxation exercise, additional religious–cult…”
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Psychometric Developments of the Hamilton Scales: The Spectrum of Depression, Dysthymia, and Anxiety
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“Other meta-analysis reports have shown that the associations of adiponectin levels with depression are not sufficiently clear in different populations, although low adiponectin levels have been observed in the European subgroup [26, 27].”
BackgroundMethod
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“org were assessed using the Parkinson Disease-Cognitive Rating Scale (PD-CRS) (27), the Hamilton Anxiety Rating Scale (HAM-A) (32), and the Hamilton Depression Rating Scale (HAM-D) (33).”
MethodInfluential
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“Remitted and healthy groups demonstrated anxiety symptoms within the “normal” range, while currently depressed subjects indicated “mild” anxiety symptoms1 (29).”
Background
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“Otherwise, the most validated and most reliable measure on a continuous scale was included, such as the Social Phobia and Anxiety Inventory for Children [38], Multidimensional Anxiety Scale for Children [39], Social Anxiety Scale for Children and Adolescents [40], Hamilton Anxiety Rating Scale [41] or Liebowitz Social…”
Method
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“Anxiety Scale.([20]) Intraoperative data collected included: length of anesthesia, length of surgery, and blood loss.”
Background
Childhood sexual abuse related to brain activity abnormalities in right inferior temporal gyrus among major depressive disorder
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“Statistical analyses were performed using the SPSS statistical package (IBM, SPSS Statistics 20).”
Method
Childhood Emotional Abuse and Psychological Distress in Gay and Bisexual Men
James, C. A., Schwartz, D. R., Roberts, K. E., Hart, T. A., Loutfy, M. R., Myers, T., & Calzavara, L. (2012) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2012.719590 · Cited by 19
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Yoga-based intervention in patients with somatoform disorders: an open label trial
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Gambling disorder: Association between duration of illness, clinical, and neurocognitive variables
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Neurocognitive performance in unmedicated patients with hoarding disorder.
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Cognitive Control Network Function in Alcohol Use Disorder Before and During Treatment With Lorazepam
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Application of the Stages of Change Scale in a clinical drug trial
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“The reliability of the total depression symptoms (Cronbach’s α = 0.87) and the total anxiety symptoms (Cronbach’s α = 0.84) derived in our investigation were comparable to other studies 38,39 .”
MethodResultInfluential
Association of Lesion Location and Fatigue Symptoms After Ischemic Stroke: A VLSM Study
Wang, J., Gu, M., Xiao, L., Jiang, S., Yin, D., He, Y., Wang, P., Sun, W., & Liu, X. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.902604 · Cited by 18
“The symptoms of depression, anxiety, and social interpersonal relationships were assessed using the 24-item Hamilton Depression Scale (HAMD24; Hamilton, 1980), 14-item Hamilton Anxiety Scale (HAMA14; Maier et al., 1988), and Lubben Social Network Scale (LSNS; Lubben, 1988), respectively.”
Method
Altered fronto-central theta-gamma coupling in major depressive disorder during auditory steady-state responses
Zhang, W., Liu, W., Liu, S., Su, F., Kang, X., Ke, Y., & Ming, D. (2022) · Clinical Neurophysiology · doi:10.1016/j.clinph.2022.11.013 · Cited by 18
“In this study, depression and its associated symptoms were reassessed using the 17-item version of the Hamilton Depression Rating Scale (HAM-D17) (Williams, 1988) and the Hamilton Anxiety Scale (HAMA) (Maier et al., 1988).”
Method
Morphometric brain characterization of refractory obsessive–compulsive disorder: Diffeomorphic anatomic registration using exponentiated Lie algebra
Tang, W., Li, B., Huang, X., Jiang, X., Li, F. Y., Wang, L., Chen, T., Wang, J., Gong, Q., & Yang, Y. (2013) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2013.07.011 · Cited by 18
Pregnancy-specific health anxiety: symptom or diagnosis?
Rathbone, A. L., & Prescott, J. (2019) · British Journal of Midwifery · doi:10.12968/bjom.2019.27.5.288 · Cited by 18

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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