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Subthreshold anxiety better defined by symptom self-report than by diagnostic interview
J Karsten1, W A Nolen, B W J H Penninx
1Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. J.Karsten@med.umcg.nl
Journal of Affective Disorders
|October 20, 2010
Summary
A Beck Anxiety Inventory (BAI) score of 11 effectively identifies clinically relevant subthreshold anxiety in individuals without full anxiety disorders. This cut-off highlights a significant portion of the functionally impaired population needing attention.
Area of Science:
- Psychiatry and Mental Health
- Clinical Psychology
- Diagnostic Assessment
Background:
- Subthreshold anxiety lacks a standardized definition, hindering clinical identification and intervention.
- Functional impairment is a key indicator for defining clinically relevant, subthreshold anxiety.
- This study addresses the need for empirical cut-offs using validated instruments.
Purpose of the Study:
- To evaluate diagnostic instruments for defining clinically relevant, subthreshold anxiety.
- To establish an empirical cut-off for subthreshold anxiety based on functional impairment.
- To compare the utility of the Composite International Diagnostic Interview (CIDI) and the Beck Anxiety Inventory (BAI).
Main Methods:
- Utilized data from 1788 subjects without full anxiety disorders in the Netherlands Study of Depression and Anxiety (NESDA).
- Employed ANCOVA to assess the association between diagnostic tools (CIDI, BAI) and functional impairment (WHODAS II).
- Conducted ROC analysis to determine the optimal BAI cut-off for identifying functionally impaired individuals with subthreshold anxiety.
Main Results:
- The Beck Anxiety Inventory (BAI) demonstrated a strong correlation with functional impairment, unlike the Composite International Diagnostic Interview (CIDI).
- A BAI score of 11 was identified as the most appropriate cut-off for defining clinically relevant subthreshold anxiety.
- This cut-off identified 36.0% of the most functionally impaired participants as having subthreshold anxiety.
Conclusions:
- The Beck Anxiety Inventory (BAI) is more suitable than the CIDI for measuring clinically relevant, subthreshold anxiety.
- A BAI score of 11 serves as a practical, albeit somewhat arbitrary, cut-off for identifying significant subthreshold anxiety.
- This finding aids in better characterizing and potentially intervening in subthreshold anxiety presentations.
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