30.Wk5Assgn
Hamilton Anxiety Rating Scale
PsycTESTS Citation: Hamilton, M. (1959). Hamilton Anxiety Rating Scale [Database record]. Retrieved from PsycTESTS. doi: https://dx.doi.org/10.1037/t02824-000
Instrument Type: Rating Scale
Test Format: A total of 14 items are rated on a five-point scale.
Source: Guy, William. (1976). ECDEU Assessment Manual, 612 pp. US Department of Health, Education and Welfare (HEW) doi: https://dx.doi.org/10.1037/e591322011-001
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048 HAMA HAMILTON ANXIETY SCALE
MH-9-48 HAMILTON ANXIETY SCALE 6-73
INSTRUCTIONS: Code 01 under Sheet Number. Be sure to record your answers in the appropriate spaces (positions through 4), Columns 1—5, on the left half of the General Scoring Sheet.
USE A NO. 2 LEAD PENCIL. BE SURE TO MAKE MARKS HEAVY AND DARK. ERASE COMPLETELY ANY MARKS YOU WISH TO CHANGE.
The Hamilton Anxiety Scale (HAMA) is a 1^-item scale formatted for use with the General Scoring Sheet. The HAMA was designed by Hamilton and intended for use with patients already diagnosed as suffering from neurotic anxiety states
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not for assessing anxiety in patients suffering from other disorders. Until the contrary is proved, it must be regarded as invalid for the rating of anxiety in any other setting. This limits the range of usefulness of the scale but, within these limits, patients can be compared meaningfully. The scale places great emphasis on the patient's subjective state. This follows from the medical bias of the author. In treatment, the patient's subjective state takes first place both as a criterion of illness, which brings the patient for treatment and as a criterion of improvement.
REFERENCES
APPLICABILITY
UTILIZATION
TIME SPAN RATED
CARD FORMAT - ITEMS
1. Hamilton, M., The Assessment of Anxiety States by Rating, Brit. J. Med. Psychol., 32, 50-55, 1959.
2. Hamilton, M., Diagnosis and Rating of Anxiety, in: Studies of Anxiety, Lader, M. H., Brit. J. Psychiat. Spec. Pub. 3, 76-79, 1969
Adults with diagnosis of anxiety neurosis
Once at pretreatment ; at least one posttreatment assess- ment. Additional ratings are at the discretion of the investigator.
Now or during the past week
CARD 01 = (19x, l4ll)
Item
1
FACTOR COMPOSITION
Hamilton has presented both centroid and orthogonal factor structures in his 1959 article. Since other ECDEU factors are orthogonal and unipolar, this structure - rather than the centroid one - will be employed for analyses. When a sufficient sample is accumulated, factor analysis will be performed on ECDEU data
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1 . Somat ic Anxiety 7 - Somatic, muscular 8 - Somatic, sensory 9 - Cardiovascular symptoms
10 - Respiratory symptoms 11 - Gastro-intest inal symptoms 12 - Gen i to-urinary symptoms 13 - Autonomic symptoms
I I . Psychic Anxiety 1 - Anxious mood 2 - Tens ion
3 - Fears k - insomnia
5 - Intellectual 6 - Depressed mood 14 - Behavior at interview
SPECIAL INSTRUCTIONS
1. Assessments are made on a 5-point scale. In practice, however, the last scale point (very severe, grossly disabling) is very rarely used for out-patients and serves more as a marker, a method of delimiting the range, rather than as a grade of practical use.
2. Each of the 14 items represents a set of symptoms grouped together according to their nature or where clinical experience indicates that they were associated. The symptom groups which serve as cues for the rater are:
1 . Anxious mood 3. Fears
Worries Anticipation of the worst Apprehension (fearful
ant icipat ion) I rri tabi 1 i ty
2. Tension
Feelings of tension Fat iguabi 1 i ty Inabi 1 ity to relax Startle response Moved to tears easily Trembl ing Feelings of restlessness
Of Dark Strangers Being left alone Large animals , etc. Traffic Crowds
Insomnia
Difficulty in falling asleep Broken sleep Unsatisfying sleep and
fatigue on waking Dreams Nightmares Night terrors
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5. Intellectual (cognitive) 11. Gastro-intestinal symptoms
Difficulty in concentration Poor memory
6. Depressed mood
Loss of interest Lack of pleasure in hobbies Depress ion Early waking Diurnal swing
7. General somatic (muscular)
Muscular pains and aches Muscular stiffness Muscular twitchings Clonic jerks Grinding of teeth Unsteady voice
8. General somatic (sensory)
Tinnitus Blurring of vision Hot and cold flushes Feelings of weakness Pricking sensations
9. Cardiovascular symptoms
Tachycardia Pa 1 p i ta t i ons Pain in chest Throbbing of vessels Fa inting feel ings Missing beat
10. Respiratory symptoms
Pressure or constriction in chest
Choking feel ings S ighings Dyspnoea
Difficulty in swallowing Wind Dyspeps ia:
pain before and after means burning sensations ful Iness
waterbrash nausea vomi ting s inking feel ings
'Working' in abdomen Borborygmi Looseness of bowels Loss of weight Constipation
12. Gen i to-urinary symptoms
Frequency of micturition Urgency of micturition Amenorrhea Menorrhagia Development of frigidity Ejaculatio praecox Loss of erection Impotence
13. Autonomic symptoms
Dry mouth Flushing Pallor Tendency to sweat G iddiness Tension headache Raising of hair
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1^. Behavior at interview
a. General b. Physiological
Tense, not relaxed Swallowing Fidgeting: hands, Belching
picking fingers. High resting pulse rate clenching, tics Respiration rate over 20/min. handkerchief Brisk tendon jerks
Restlessness: pacing Tremor
Tremor of hands Dilated pupils Furrowed brow Exophthalmos Strained face Sweating increased muscular tone Eye-1 id^ twitching Sighing respirations Facial pallor
DOCUMENTATION
a. Raw score printout b. Factor score printout c. Means and standard deviations of factor scores d. Variance analyses
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