Is the Beck Anxiety Inventory a good tool to assess the severity of anxiety? A primary care study in the Netherlands Study of Depression and Anxiety (NESDA)
Open accessAbstract
BACKGROUND: Appropriate management of anxiety disorders in primary care requires clinical assessment and monitoring of the severity of the anxiety. This study focuses on the Beck Anxiety Inventory (BAI) as a severity indicator for anxiety in primary care patients with different anxiety disorders (social phobia, panic disorder with or without agoraphobia, agoraphobia or generalized anxiety disorder), depressive disorders or no disorder (controls). METHODS: Participants were 1601 primary care patients participating in the Netherlands Study of Depression and Anxiety (NESDA). Regression analyses were used to compare the mean BAI scores of the different diagnostic groups and to correct for age and gender. RESULTS: Patients with any anxiety disorder had a significantly higher mean score than the controls. A significantly higher score was found for patients with panic disorder and agoraphobia compared to patients with agoraphobia only or social phobia only. BAI scores in patients with an anxiety disorder with a co-morbid anxiety disorder and in patients with an anxiety disorder with a co-morbid depressive disorder were significantly higher than BAI scores in patients with an anxiety disorder alone or patients with a depressive disorder alone. Depressed and anxious patients did not differ significantly in their mean scores. CONCLUSIONS: The results suggest that the BAI may be used as a severity indicator of anxiety in primary care patients with different anxiety disorders. However, because the instrument seems to reflect the severity of depression as well, it is not a suitable instrument to discriminate between anxiety and depression in a primary care population.
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BAI has high reliability and good validity.
“The Beck Anxiety Inventory (BAI) is a scale that measures anxiety using a list of 21 anxiety symptoms and has high reliability and good validity (Beck et al., 1988; Muntingh et al., 2011).”
From Internet-based treatment for vulvodynia (EMBLA) – Study protocol for a randomised controlled study (2021) · cites this paper as Muntingh et al., 2011
The Methods (Assessment; page not specified) describe the 21-symptom BAI and report high internal consistency (α = .92) and one-week test–retest reliability of .75. The Conclusions (page not specified) support its use as an anxiety-severity indicator in primary care, but the paper also finds that it reflects depression severity and cannot reliably discriminate between anxiety and depression there. The unqualified claim of good validity omits that limitation. (LLM, conf=0.88)
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- Authors
- Muntingh, A. D., van der Feltz-Cornelis, C. M., van Marwijk, H. W., Spinhoven, P., Penninx, B. W., & van Balkom, A. J.
- Affiliations
- Trimbos Institute (NL)
- Leiden University (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Muntingh, Anna DT
- Spinhoven, Philip
- Penninx, Brenda WJH
- Venue
- BMC Family Practice
- Published
- 2011-07-04
- Volume
- 12
- Issue
- 1
- Pages
- 66-66
- ISSN
- 1471-2296 (ISSN-L)
- PMC
- PMC3224107
- OpenAlex
- W2097904666
- Cited by
- 147
- References
- 37
- Citations by year
- 2026: 1 · 2025: 13 · 2024: 10 · 2023: 17 · 2022: 13 · 2021: 9 · 2020: 14 · 2019: 16 · 2018: 19 · 2017: 8 · 2016: 6 · 2015: 7 · 2014: 7 · 2013: 7
- FWCI
- 5.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Family Practice (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- Research portal (Tilburg University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- VU Research Portal (publishedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Explorer (The University of Manchester) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- Universiteit Leiden (10‐000‐1002)
- Vrije Universiteit Amsterdam
- GGZ inGeest
- Rivierduinen
- GGZ Friesland
- GGZ Drenthe
- Nederlands Instituut voor Onderzoek van de Gezondheidszorg (10-000-1002)
- Trimbos-instituut
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- Beck Anxiety Inventory, anxiety levels, anxiety disorders, primary care, panic disorder with agoraphobia, agoraphobia, social anxiety disorder, generalized anxiety disorder, comorbid depression, NESDA
- MeSH terms
- Adolescent, Adult, Aged, Anxiety, Female, Humans, Male, Middle Aged, Netherlands, Primary Health Care, Psychological Tests, Severity of Illness Index, Young Adult
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