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Anxiety Status Inventory
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About Anxiety Status Inventory
Scale Name
Anxiety Status Inventory
Author Details
W W. K. Zung
Translation Availability
English
Background/Description
The Anxiety Status Inventory (ASI), developed by William W.K. Zung in 1971, is a clinician-administered tool designed to measure the severity of anxiety symptoms as a psychiatric disorder, rather than a temporary emotional state or personality trait. The ASI was created alongside Zung’s Self-Rating Anxiety Scale (SAS), allowing for direct comparison between clinician ratings and patient self-reports.
The ASI is composed of 20 items reflecting the most common symptoms of generalized anxiety disorders as classified in psychiatric diagnostic systems. These include five affective symptoms (e.g., apprehension, fear, and tension) and 15 physiological symptoms (e.g., trembling, sweating, dizziness, palpitations).
The instrument is unique because it integrates clinical observation with patient self-reporting during a structured interview. Ratings consider intensity, duration, and frequency of symptoms experienced in the past week, providing a standardized quantitative score. By focusing on anxiety disorder as a clinical entity, the ASI avoids cultural biases and enhances cross-population applicability.
Administration, Scoring and Interpretation
- Obtain a Copy: The ASI is published by W.W.K. Zung and can be accessed through clinical psychology and psychiatry research resources.
- Explain the Purpose: Inform participants that the ASI evaluates current clinical symptoms of anxiety, not just everyday stress.
- Provide Instructions: The clinician interviews the patient, using the 20 items as a guide while also probing for details about severity, duration, and frequency.
- Approximate Time: The ASI generally takes 10–15 minutes to complete.
- Administer the Scale: Clinicians score each item on a 4-point Likert scale (1 = none, 4 = severe), then calculate a total score ranging from 20 to 80, which is transformed into an index score (25–100).
Reliability and Validity
The ASI demonstrates sound psychometric properties:
- Split-half reliability = 0.71
- Internal consistency (Cronbach’s alpha) = 0.85 in clinical populations
- Test-retest reliability across different samples has been shown to be acceptable
- Correlation between clinician-administered ASI and the self-rated SAS = 0.66 overall, and 0.74 for diagnosed anxiety patients.
- Correlates significantly with established measures:
- Discriminant validity: While the ASI distinguishes between anxious and unaffected individuals, overlap exists with depression symptoms, requiring complementary tools (e.g., Zung’s Self-Rating Depression Scale).
Cut-off scores:
- <44: Normal range
- 45–59: Minimal to moderate anxiety
- 60–74: Marked to severe anxiety
- 75+: Extreme anxiety
Available Versions
20-Items
Reference
Zung, W. W. (1971). A rating instrument for anxiety disorders. Psychosomatics: Journal of Consultation and Liaison Psychiatry.
Important Link
Scale File:
Frequently Asked Questions
Q1. What is the difference between the ASI and SAS?
The ASI is clinician-rated, while the SAS is self-rated. Both measure the same 20 anxiety symptoms.
Q2. What does a high ASI score indicate?
A higher score reflects greater severity of anxiety symptoms, with cut-off points identifying normal, moderate, severe, and extreme anxiety levels.
Q3. Can the ASI be used across cultures?
Yes. Zung emphasized that symptoms of anxiety disorder are largely universal, and the ASI has been validated internationally.
Q4. How long does it take to complete the ASI?
It generally requires 10–15 minutes during a clinical interview.
Q5. Is the ASI still in use today?
Yes. It remains a widely used clinical and research tool for evaluating anxiety disorders, often alongside the SAS and other standardized measures.
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