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Rehabilitation Measures Database

Spinal Cord Injury – Quality of Life Anxiety

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The SCI-QOL Anxiety instrument is used to assess symptoms of anxiety in individuals with spinal cord injury (SCI).

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Instrument Details

Acronym SCI-QOL Anxiety

Area of Assessment

Mental Health
Quality of Life
Negative Affect
Stress & Coping

Assessment Type

Patient Reported Outcomes

Administration Mode





  • Spinal Cord Injury


Key Descriptions

  • The SCI-QOL Anxiety measure is an item response theory (IRT)-calibrated item bank with 25 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or short form (SF). Many items are shared with the PROMIS (15 of 25 items) and Neuro-QOL (20 of 25 items) Anxiety item banks.

Number of Items


Short form: 9

CAT: 4-12

Equipment Required

  • The Short Form requires only the printed form and a pencil.
  • A CAT administration requires a desktop, laptop, or tablet computer with internet connection and login to
  • Access to the short form, and administration of CATs through Assessment Center, is available through

Time to Administer

Less than 5 minutes

Required Training

Reading an Article/Manual

Age Ranges


18 - 64


Elderly Adults

65 +


Instrument Reviewers

Review completed by Pamela Kisala, M.A. and Matthew Cohen, Ph.D.

ICF Domain

Body Function

Measurement Domain



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Spinal Injuries

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Standard Error of Measurement (SEM)

Depends on the mode of administration:

  • Full Item Bank: Mean SEM= 0.22
  • 9-Item Fixed-length CAT: Mean SEM= 0.29
  • Variable-length CAT (Min 4): Mean SEM= 0.32
  • Variable-length CAT (Min 8): Mean SEM= 0.29
  • 9-Item Short Form: Mean SEM= 0.33

Minimal Detectable Change (MDC)

Calculated from SEM:

  • Full Item Bank: MDC= 0.51
  • 9-Item Fixed-length CAT: MDC= 0.63
  • Variable-length CAT: MDC= 0.67

Cut-Off Scores

Kisala et al. (2015) created a "cross-walk" table to transform SCI-QOL Anxiety scores to scores on the GAD-7, a gold standard measure of anxiety with well-established cut scores.

The SCI-QOL Anxiety scores below are the equivalent of GAD-7 cutoff scores:

  • Mild Anxiety: T-score of 49-55
  • Moderate Anxiety: T-score of 56-61
  • Severe Anxiety: T-Score of 62+

Normative Data

General population (2000 U.S. Census). The normative data reference the calibration sample from PROMIS, which matches the demographics of the 2000 U.S. Census.

Test/Retest Reliability

Traumatic SCI (Kisala et al., 2015)

Full Item Bank:

  • Excellent: (Pearson's r= 0.80)
  • Excellent: (ICC = .80)

Internal Consistency

Traumatic SCI (Kisala et al., 2015)

  • Full Item Bank - Excellent: (Cronbach’s alpha= .95)
  • 9-Item Fixed CAT - Excellent: (Cronbach's alpha= .92)
  • Variable-length CAT (Min 4) - Excellent: (Cronbach's alpha= .91)
  • Variable-length CAT (Min 8) - Excellent: (Cronbach's alpha= .92)
  • 9-Item Short Form - Excellent: (Cronbach's alpha= .90)

Criterion Validity (Predictive/Concurrent)

 Traumatic SCI (Kisala et al., 2015)

  • Excellent: Predicting GAD-7 scores (r= .67)

Construct Validity

Traumatic SCI (Tulsky et al., in preparation)

The SCI-QOL Anxiety item bank demonstrated good convergent validity by correlating strongly with measures of:

  • Depression (PHQ-9 r= .61)
  • Life Satisfaction (Satisfaction with Life Scale r= -.53),
  • Resilience (SCI-QOL Resilience r= -.68),
  • Positive affect (SCI-QOL Positive Affect r= -.59).

The SCI-QOL Anxiety item bank demonstrated good discriminant validity by not correlating with measures of:

  • Fine motor functioning (SCI-QOL Fine Motor r= -.046)

Content Validity

Some SCI-QOL items were derived from the focus groups and cognitive interviews that founded the PROMIS and/or Neuro-QOL measurement systems. The Neuro-QOL focus groups comprised patients with neurological illness (n= 64) and caregivers (n= 19).

Other SCI-QOL items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI (n=42).

Face Validity

Not statistically assessed, but content was generated from individuals with SCI and expert clinicians, so face validity is  believed to be strong.

Floor/Ceiling Effects

Traumatic SCI (Kisala et al., 2015)


Full Item Bank:

  • Floor Effects: Adequate to Excellent (2.8%)
  • Ceiling Effects: Excellent (0.1%)

9-Item Fixed-length CAT:

  • Floor Effects: Adequate to Excellent (7.5%)
  • Ceiling Effects: Excellent (0.1%)

Variable-length CAT (Min 4):

  • Floor Effects: Adequate to Excellent (6.8%)
  • Ceiling Effects: Excellent (0.1%)

Variable Length CAT (Min 8):

  • Floor Effects: Adequate to Excellent (6.8%)
  • Ceiling Effects: Excellent (0.1%)

9-Item Short Form:

  • Floor Effects: Adequate to Excellent (6.4%)
  • Ceiling Effects: Excellent (0.1%)


Kisala et al. (2015). Measuring anxiety after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Anxiety item bank and linkage with GAD-7. Journal of Spinal Cord Medicine, 38(3), 315-325.

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