Diagnosis of an anxiety or related disorder

Assessment Instruments for Diagnosis of Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is a psychiatric condition characterized by excessive and persistent worry about a wide range of issues and situations in life rather than a single event (DeMartini et al., 2019). Individuals suffering from this condition are often anxious about their health, work, families, and other issues. GAD causes fatigue, restlessness, sleep disturbance, irritability, and other problems (DeMartini et al., 2019). Such negative effects make it necessary to address the condition.

There are several assessment instruments used for the diagnosis of GAD. One of such instruments is the Generalized Anxiety Disorder Severity Scale (GADSS). According to Shear et al (2006), GADSS was specifically designed for measuring the severity of GAD. It is an appropriate assessment instrument useful for detection of the associated symptoms of the GAD. These include sleep disturbance, muscle tension, irritability, restlessness, fatigue, and difficulty concentrating. The instrument can be used to measure a patient’s response to therapy since it monitors the severity of the condition throughout the treatment period. GADSS is associated with good treatment sensitivity, validity, and reliability. One of the major limitations of the instrument is that the accuracy of its measures depends on the stability of the symptoms of the affected individual.

Another instrument that is helpful in diagnosing GAD is Hamilton Anxiety Rating Scale (HAM-A). As far as Thompson (2015) is concerned, HAM-A was designed to measure the various associated symptoms of the health issue. The appropriateness of the instrument lies within the fact that it contains both somatic and psychic subscales of anxiety. The psychic subscale is used to asses GAD severity just like the GADSS. It focuses on items associated with affective and subjective cognitive elements of anxiety such as tension, mood, and fear. On its part, the somatic subscale emphasizes on less typical characteristics of GAD. These include cardiovascular and respiratory symptoms. Since it also assesses the severity of the health condition in the entire period of treatment, HAM-A can be used to measure therapy response. The instrument has become a reliable and valid industrial standard for clinical trials associated with the treatment of GAD. The main limitation of HAM-A is that it cannot be used to evaluate excessive worry that is difficult to control. Yet this type of worry takes a center stage in the assessment and diagnosis of GAD.


DeMartini, J., Patel, G., & Fancher, T. L. (2019). Generalized Anxiety Disorder. Annals of Internal Medicine. https://doi.org/10.7326/AITC201904020

Shear, K., Belnap, H., Mazumdar, S., Houck, P., & Rollman, B. L. (2006). Generalized Anxiety Disorder Severity Scale (GADSS): A Preliminary Validation Study. Depression and Anxiety, 23 (2): 77-82. https://doi.org/10.1002/da.20149

Thompson, E. (2015). Hamilton Rating Scale for Anxiety (HAM-A). Occupational Medicine, 65: 601. doi:10.1093/occmed/kqv054

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