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Suffering from Anxiety? New Scale May Tell


A new standardized questionnaire and scale to measure anxiety has been developed by experts in the department of psychiatry at Rhode Island Hospital. The new scale, called the Clinically Useful Anxiety Outcome Scale (CUXOS), has been shown to be a reliable and valid measure of anxiety.

Within the field of psychology and psychiatry, practitioners regularly count on standardized scales to help them evaluate patients who present with psychiatric disorders. As Mark Zimmerman, MD, director of outpatient psychiatry at Rhode Island Hospital and co-developer of the new scale noted, “If the optimal delivery of mental health treatment ultimately depends on examining outcome, then precise, reliable, valid, informative, and user-friendly measurement is critical to evaluating the quality and efficiency of care in clinical practice.”

Zimmerman and his colleagues believe they have developed such a measurement tool. Along with being accurate, one thing that is special about this new scale is that it takes less than two minutes for patients to complete, and clinicians can score the patients’ answers in less than 15 seconds.

The combination of accuracy and speed is highly desirable. Zimmerman pointed out that “Clinicians are already overburdened with paperwork, and adding to this load by requiring repeated detailed evaluations using instruments that are available is unlikely to meet with success.” He and his colleagues noted that only 11 percent of psychiatrists regularly use standardized scales to evaluate outcomes when treating depression or anxiety.

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The researchers put the new scale through rigorous testing, including having some patients take the test twice to examine test-retest reliability, and having a subset of patient complete other self-report tests to evaluate discriminant and convergent validity, two measures that are critical for a program to be valid.

Overall, CUXOS had high internal consistency and test-retest reliability, it was highly correlated with other self-report measures of anxiety than with measures of depression and other psychiatric conditions, and the scores were significantly higher in psychiatric outpatients with anxiety disorders than other psychiatric disorders.

Anxiety disorders include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and phobias. According to the National Institute of Mental Health, approximately 40 million Americans ages 18 and older have an anxiety disorder. Most people with one anxiety disorder also have another anxiety disorder.

Zimmerman and colleagues believe they have developed an effective scale clinicians can easily incorporate into their practices as a general measure of anxiety. They also note that additional research should be done to “explore both clinicians’ and patients’ perspectives as to whether the use of a general or disorder specific scales is preferred.”

National Institute of Mental Health
Rhode Island Hospital, news release Mar. 9, 2010