Support for the reliability and validity of a six-item state anxiety scale derived from the State-Trait Anxiety Inventory
Open accessAbstract
Identifying the most efficient and theoretically appropriate methods to assess patient anxiety in fast-paced medical environments may be beneficial for clinical purposes as well as for research. The purpose of this study was to examine the reliability and validity of two previously published six-item versions of the State form of the State-Trait Anxiety Inventory (STAI) and to identify the version that would be most appropriate to use with a sample of parents who had infants with normal or abnormal newborn screens. In the current study, confirmatory factor analyses were conducted to evaluate the fit of the two six-item forms with STAI data collected at three time points from 288 parents of 150 infants. Study groups of parents were based upon infant newborn screens and subsequent diagnostic testing to include cystic fibrosis (CF; n = 26), congenital hypothyroidism (CH; n = 39), CF Carriers (CF–C; n = 45), and healthy infants (H; n = 40). The results showed the version containing items 1, 3, 6, 15, 16, and 17 of the State form of the STAI to be a better fitting model across all three time points, and it had better internal consistency than the version containing items 5, 9, 10, 12, 17, and 20. Both short forms were highly correlated with the 20-item STAI score, and all internal consistency reliabilities were greater than .90. It was concluded that the version containing items 1, 3, 6, 15, 16, and 17 of the State Anxiety scale was a reliable and valid instrument for this study sample.
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The State-Trait Anxiety Inventory Short Form measures state anxiety and trait anxiety (6 items, Cronbach's alpha >0.90).
“The State-Trait Anxiety Inventory Short Form measures state anxiety (how one feels at the moment) and trait anxiety (how one generally feels) (6 items, Cronbach’s alpha >0.90).83 84”
From Coached, Coordinated, Enhanced Neonatal Transition (CCENT): Protocol for a multicentre pragmatic randomised controlled trial of transition-to-home support for parents of high-risk infants (2021) · cites this paper as [84]
The Abstract identifies the six-item short forms as versions of the State scale, not measures of both state and trait anxiety. In the Results, their Cronbach’s alphas range from .74 to .82; values above .90 are reported for the 20-item scale, not the six-item short forms. (LLM, conf=0.91)
Experimental — accuracy not yet measuredThe 6-item version of the State-Trait Anxiety Inventory (STAI) is validated and inquires about anxiety over the past month.
“a validated 6-item version of the State-Trait Anxiety Inventory (STAI; [70]) that inquires about anxiety over the past month.”
From A randomized controlled trial of a group acceptance-based intervention for cancer survivors experiencing anxiety at re-entry ('Valued Living'): Study protocol (2019) · cites this paper as [70]
The Results and Discussion support the reliability and validity of six-item STAI State Anxiety scales. But the Abstract describes state anxiety as anxiety experienced in present circumstances, and the Background calls it a transient state; neither supports the claim that the scale asks about the past month. No page numbers are available in our copy. (LLM, conf=0.90)
Experimental — accuracy not yet measuredState anxiety was measured using the State Anxiety Inventory short form (6-items).
“State anxiety was measured using the State Anxiety Inventory (SAI) short form (6-items; [32,33]).”
From Box breathing and prolonged exhalation reduces markers of physiological stress reactivity in response to a virtual trier social stress test (2026) · cites this paper as [33]
The STAI-6 is highly correlated to the original 20-item STAI and has good sensitivity to detect group differences in anxiety.
“The STAI-6 is a 6-item shortened version of the 20-item STAI, but has been shown to be highly correlated to the original scale and good sensitivity to detect group differences in levels of anxiety [21].”
From Gender Differences in Psychological Stress Factors of Physical Therapy Degree Students in the COVID-19 Pandemic: A Cross-Sectional Study (2022) · cites this paper as [21]
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- Authors
- Tluczek, A., Henriques, J. B., & Brown, R. L.
- Affiliations
- University of Wisconsin–Madison (US)
- Venue
- Journal of Nursing Measurement
- Publisher
- Springer Publishing Company
- Published
- 2009-05
- Volume
- 17
- Issue
- 1
- Pages
- 19-28
- ISSN
- 1061-3749 (ISSN-L)
- 1945-7049
- PMC
- PMC2776769
- OpenAlex
- W2016709782
- Cited by
- 308
- References
- 7
- Citations by year
- 2026: 19 · 2025: 17 · 2024: 25 · 2023: 45 · 2022: 38 · 2021: 36 · 2020: 32 · 2019: 17 · 2018: 11 · 2017: 12 · 2016: 15 · 2015: 12 · 2014: 7 · 2013: 15 · 2012: 5
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Nursing Measurement (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23 HD42098, K23HD042098)
- 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 › Education › Health Education and Validation
- Keywords
- state anxiety, State-Trait Anxiety Inventory, parental anxiety, newborn screening, cystic fibrosis, congenital hypothyroidism, cystic fibrosis carriers, infant diagnosis, scale validation, internal consistency, factor structure
- MeSH terms
- Adult, Anxiety, Congenital Hypothyroidism, Cystic Fibrosis, Factor Analysis, Statistical, Female, Humans, Infant, Newborn, Male, Parents, Personality Inventory, Psychometrics, Reproducibility of Results, Chi-Square Distribution
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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