A comparison of the dimensionality of the Hamilton Rating Scale for anxiety and the DSM-5 Anxious-Distress Specifier Interview

• Published in: Psychiatry research 2020-02, Vol.284, p.112788-112788, Article 112788
• Main Authors: Rodriguez-Seijas, Craig, Thompson, Justine S., Diehl, Joseph M., Zimmerman, Mark
• Format: Article
• Language: English
• Subjects: Anxiety; Assessment; Depression; DSM-5 Anxious Distress Specifier Interview; Hamilton Anxiety Scale
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2020.112788

•The factor structure of the Hamilton Rating Scale for Anxiety (HAM-A) is confounded by the assessment of symptoms of depression.•The DSM-5 Anxious Distress Specifier has been proposed to measure anxiety among individuals with a major depressive episode, though there is scant empirical literature on the nature of anxious distress.•The factor structures of the HAM-A and one assessment tool of anxious distress were assessed among psychiatric patients with and without a current major depressive disorder.•Optimal HAM-A factor structure differed based upon diagnosis of a major depressive disorder, while the anxious distress specifier interview demonstrated similar factor structure in both groups. The Hamilton Rating Scale for Anxiety (HAM-A) is one of the most widely used measures for assessing anxiety in research settings. However, it has been criticized for its inclusion of items that assess depressive symptoms. The DSM-5 Anxious Distress Specifier Interview (DADSI), developed as one assessment tool for measuring anxiety among depressed patients, demonstrates similar validity when compared with the HAM-A. However, its underlying factor structure has never been explored. The goal of the current study, therefore, was to compare the underlying factor structures of the HAM-A and the DADSI among clinically depressed (n = 576) and non-depressed (n = 146) patient samples. While two- and three-factor structures of the HAM-A fit similarly well among patients with a current major depressive episode, the three-factor structure—with anxiety and depressive symptoms forming separate factors—fit best among patients without a current major depressive episode. The DADSI was best represented by a single-factor model in both groups. The DADSI showed stronger associations with anxiety and somatic symptoms than with depressive symptoms of the HAM-A. These findings add to the characterization of the DADSI, and further highlight an important consideration for the use of HAM-A as a measure of anxiety in outcome studies.