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Beck Anxiety Inventory

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Purpose

The BAI assesses anxiety symptoms and symptom severity. The BAI can discriminate anxiety from depression. The tool is most appropriate for use with ages 17 – 80 years across a variety of clinical populations.

Link to Instrument

Instrument Details

Acronym BAI

Area of Assessment

Quality of Life

Assessment Type

Patient Reported Outcomes

Cost

Not Free

Cost Description

For pricing information, please visit https://www.pearsonclinical.com/psychology/products/100000251/beck-anxiety-inventory-bai.html#tab-pricing

Diagnosis/Conditions

  • Pain Management
  • Pediatric + Adolescent Rehabilitation

Key Descriptions

  • 4-point Likert scale responses for anxiety symptoms and severity within 1 week:
    0 = Not at all
    1 = mildly - but didn’t bother me much
    2 = Moderately - it wasn’t pleasant at times
    3 = Severely – I can barely stand it
  • Total score is calculated by calculating the sum of 21 items
  • Minimum score of 0 and a maximum score of 63
  • Score Interpretation:
    0 - 7 = minimal anxiety
    8 – 15 = mild anxiety
    16 – 25 = moderate anxiety
    26 – 63 = severe anxiety

Number of Items

21

Equipment Required

  • Internet access and electronic device for computer test
  • Paper form and writing utensil for paper test

Time to Administer

5-10 minutes

Required Training

No Training

Age Ranges

Adult

18 - 44

years

Older Adult

45 - 65

years

Instrument Reviewers

This instrument was reviewed by Michele Voight, PTA, MPA and Jessica Marone.

ICF Domain

Body Function

Measurement Domain

Emotion

Considerations

Based on normative data by Gillis et al., (1995 ) individuals 18 – 44 years old demonstrated a higher anxiety rating than those 45-65 years old.

Non-Specific Patient Population

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Normative Data

Healthy adults: (Gillis, et al., 1995; BAI: n=267, adults between the ages of 18-65)

Percentile

All Scores

18 – 44 yrs. old

45 -65 yrs. old

10th

0

0

0

20th

0

0

0

25th

0

1

0

30th

1

2

0

40th

2

3

1

50th

3

4

2

60th

5

6

3

70th

7

9

5

75th

8

10

6

80th

10

12

6

90th

17

19

9

  •  For overall sample, mean score = 6.6, (8.1)
  • Younger participants (aged 18 – 44) exhibited higher BIA scores (mean  = 7.3, (8.4)) than older participants (aged 45-65) (mean = 4.4, ( 6.3)

Internal Consistency

Healthy adults: (Wetherell and Gatz,2005; n = 32; mean age = 67.8 (7.1) years)

  • Excellent internal consistency (Chronbach’s alphas .81)

(Osman et al., 1997; n = 350; n = 145 males, mean age = 20.95 (3.52); n = 205 females, mean age = 21.64 (5.58) years)

  • Excellent internal consistency (Chronbach’s alphas .90)

Mental Health

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Cut-Off Scores

Psychiatric outpatients: (Kabacoff et al., 1997 n = 154 non-psychotic adults over 55 years of age;  mean age = 65.86 (8.54) years)

  • No single cutoff score provided both high sensitivity and high specificity

    Cutoff

    Sensitivity

    Specificity

     0 – 7 minimum anxiety

    1.00 - .94

    .08 - .32

     8 – 15 mild anxiety

    .94 - .67

    .35 - .60

    16 – 25 moderate anxiety

    .67 - .33

    .62 - .84

    26 – 63 severe anxiety

    .28 - .00

    .85 - .99

Test/Retest Reliability

Adolescent psychiatric patients:  (Osman et al., 2002;  n = 240; mean age = 15.7 (.94) years)

  • Adequate test-retest reliability (ICC =.71)

Panic disorder with agoraphobia: (de Beurs et al.,1997; n = 82; mean age = 36.9 (9.1) years; mean duration of illness = 11.8 (8.1) years)

  • Excellent test-retest reliability (ICC =.83)

Psychiatric outpatients: (Beck et al., 1988; n = 1,086, 456 male mean age = 36.55 (12.41) years; 630 female, mean age = 35.69 (12.12) years)

  • Excellent test-retest reliability (ICC =.75)

Internal Consistency

General anxiety disorder: (Wetherell and Gatz, 2005; n = 75; mean age = 67.1 (8.2) years)

  •  Excellent internal consistency (Chronbach’s alphas .90)

Adolescent psychiatric patients: (Osman et al., 2002)

  • Excellent internal consistency (Chronbach’s alphas .92)

Panic Disorder with agoraphobia: (de Beurs et al., 1997)

  • Excellent internal consistency (Chronbach’s alphas .90)

Sleep disorders: (Sanford et al., 2008; n = 303; mean age = 47.8 (13.0) years)

  • Excellent internal consistency (Chronbach’s alphas .92)

Psychiatric outpatients: (Kabacoff, et al., 1997)

  • Excellent internal consistency (Chronbach’s alphas .90)

(Beck et al., 1988)

  • Excellent internal consistency (Chronbach’s alpha = .92)

Construct Validity

Convergent Validity

General Anxiety Disorders: (Wetherell & Gatz, 2005)

  • Adequate correlation of the Hamilton Anxiety Rating (.57)

Discriminant Validity

Psychiatric outpatients: (Kabacoff et al., 1997)

  • Excellent: Mean score differences between patients who met criteria for a current diagnosis of an anxiety disorder, and patients who did not meet criteria for a current anxiety disorder. A significant mean total score difference between patients with an anxiety disorder (M = 21.75, SD = 13.11) and patients without an anxiety disorder (M = 14.44, SD = 10.93) was obtained

(Beck et al., 1988)

Excellent: BAI-somatic subscale yielded a significant mean difference (t (124.4) = 3.42, p < .0001) between patients with an anxiety disorder (M = 11.54, SD = 9.05) and patients without an anxiety disorder (M = 7.46, SD = 6.99). Similarly, a significant mean difference (t (215) = 4.75, p < .00001) between patients with (M = 10.21, SD = 5.40) and without an anxiety disorder (M = 6.73, SD = 5.00) was obtained on the BAI-subjective subscale.

Bibliography

 Beck, A., Brown, G. Epstein, N., Steer, R. A. (1988). An inventory for measuring clinical anxiety:  psychometric properties. Journal of Consulting and Clinical Psychology 56(6). PP 893-897 DOI:  10.1.1.471.4319 Find it

de Beurs, E., Wilson, K. A., Chanmbless, D. L., Goldstein, A.J., Feske, U. (1997). Convergent and divergent validity of the Beck Anxiety Inventory for patients with panic disorder and agoraphobia. Depression and Anxiety 6:140-146. Wiley Online.

Gillis, M.M., Hagga, D. A. F., Ford, G. T., (1995). Normative values for the Beck Anxiety Inventory , Fear Questionnaire, Penn State Worry Questionnaire, and Social Phobia and Anxiety Inventory. Psychological Assessment. 7(4). 450-455. Source: PubMed

Julian, L. J. (2011). Measures of Anxiety. State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care & Research 63(11)  November 2011, pp S467 – S472. DOI 10.1002/acr.20561 Find it on Wiley Online Library

Kabacoff, R. I., Segal, D. L., Hersen, M., Van Hasselt, V. B., (1997). Psychometric properties and diagnostic utilities of the Beck Anxiety Inventory and the State-Trait Anxiety Inventory with older adult psychiatric outpatients. Journal of Anxiety Disorders. 11(1) 33-47.  DOI:10.1016/S0887- 6185(96)00033-3 Source: PubMed

Osman, A., Hoffman, J., Barrios, F. X., Kopper, B. A., Breitenstein, J. L., & Hahn, S. K. (2002). Factor structure, reliability, and validity of the Beck Anxiety Inventory in adolescent psychiatric inpatients. Journal Of Clinical Psychology, 58(4), 443-456. Find it on EBSCOhost

Osman, A., Kopper, B.A., Barrios, F. X., Osman, J. R, Wade, T (1997) The Beck Anxiety Inventory: reexamination of factor structure and psychometric properties. Journal of Clinical Psychology, 53(1), 7-14. Find it on EBSCOhost

Pearson. Clinical Psychology. http://www.pearsonclinical.com/psychology/products/100000251/beck- anxiety-inventory-bai.html#tab-details Accessed September 5, 2017

Sanford, S. D., Bush, A. J., Stone, K.C., Lichstein, K.L., Aguillard, N., (2008). Psychometric evaluation of the  Beck Anxiety Inventory: a sample of sleep-disordered breathing. Behavioral Sleep  Medicine.6:193-205. DOI: 10.1080/15402000802162596. Source: PubMed

Wetherell, J. L., & Gatz, M. (2005). The Beck Anxiety Inventory in older adults with generalized anxiety  disorder. Journal of Psychopathy and Behavioral Assessment 27(1), March 2005. DOI:  10.1007/s10862-005-3261-3 Find it on EBSCOhost