The Hamilton Anxiety Rating Scale (HAM-A) is a psychological questionnaire used by clinicians to rate the severity of a patient's anxiety. Anxiety can refer to things such as "a mental state...a drive...a response to a particular situation…a personality trait...and a psychiatric disorder."[1] Though it was one of the first anxiety rating scales to be published, the HAM-A remains widely used by clinicians.[2] It was originally published by Max Hamilton in 1959. For clinical purposes, and the purpose of this scale, only severe or improper anxiety is attended to. This scale is considered a "clinical rating" of the extensiveness of anxiety, and is intended for individuals that are "already diagnosed with anxiety neurosis."[3]
The scale consists of 14 items designed to assess the severity of a patient's anxiety. Each of the 14 items contains a number of symptoms, and each group of symptoms is rated on a scale of zero to four, with four being the most severe. All of these scores are used to compute an overarching score that indicates a person's anxiety severity.[4] The Hamilton Anxiety Rating scale has been considered a valuable scale for many years, but the ever-changing definition of anxiety, new technology, and new research has had an effect on the scale's perceived usefulness.[5] As a result, there have been changes, and challenges, to the original version of the scale over time.[6]
^McDowell, I., Newell, C., & McDowell, I. (2006). Measuring health: a guide to rating scales and questionnaires (Vol. 268). New York: Oxford University Press.
^Maier W, Buller R, Philipp M, Heuser I. The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord 1988;14(1):61–8.
^Hamilton M.The assessment of anxiety states by rating. Br J Med Psychol 1959; 32:50–55.
^Vaccarino, A. L., Evans, K. R., Sills, T. L., & Kalali, A. H. (2008). Symptoms of anxiety in depression: assessment of item performance of the Hamilton Anxiety Rating Scale in patients with depression. Depression & Anxiety (1091-4269), 25(12), 1006-1013. doi:10.1002/da.20435
^Kobak, K. A., Reynolds, W. M., & Greist, J. H. (1993). Development and validation of a computer-administered version of the Hamilton Rating Scale. Psychological Assessment, 5(4), 487-492. doi: 10.1037/1040-3590.5.4.487
^Koerner, N., Antony, M. M., & Dugas, M. J. (2010). Limitations of the Hamilton Anxiety Rating Scale as a primary outcome measure in randomized, controlled trials of treatments for generalized anxiety disorder. The American Journal of Psychiatry, 167(1), 103-104. doi:10.1176/appi.ajp.2009.09091264
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