Readability of self-report measures of depression and anxiety

As the demand for accountability in service provision settings increases, the need for valid methods for assessing clinical outcomes is of particular importance. Self-report measures of functioning are particularly useful in the assessment of psychological functioning, but a vital factor in their validity and transportability is the reading level needed to comprehend them. We evaluated the reading grade levels required to comprehend the instructions and items from 105 evidence-based self-report measures of depression and anxiety. Results indicated substantial variability in readability among measures, with anxiety measures generally requiring a higher reading level relative to depression measures. In some cases, reading levels required for measure instructions were particularly high, and most measures were written at or above the mean reading grade level in the United States. This analysis provides information that may aid in selecting appropriate symptom measures in clinical and research settings. Future directions, including the development of measures for individuals with low levels of literacy, are discussed.