Comprehension of self-report evidence-based measures of anxiety

Depress Anxiety. 2011 Jul;28(7):607-14. doi: 10.1002/da.20827. Epub 2011 May 26.


Background: Given their applicability in diverse settings and for a wide range of purposes, the generalizability of self-report symptom measures is particularly important. An understudied factor in the development and validation of self-report measures is the degree to which they are difficult to comprehend. This study evaluated the difficulty of self-report measures of anxiety with respect to several domains, including formatting, length, and linguistic problems.

Methods: Ninety-two evidence based measures of anxiety were evaluated for comprehension level.

Results: The majority of anxiety measures included challenging elements of formatting, linguistic ability, and readability. Measures of obsessive-compulsive disorder were associated with the highest level of comprehension (i.e., greatest difficulty).

Conclusions: The validity of self-report measures relies on the ability of respondents to understand the instructions and measure items. Factors related to the comprehension of self-report measures should be included among the basic psychometric properties in measure development and validation. Future research on the development of self-report measures that can be more broadly applicable across levels of education and literacy are of particular importance to research, clinical, and public health agendas.

Publication types

  • Comparative Study
  • Review
  • Validation Study

MeSH terms

  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / psychology
  • Comprehension*
  • Evidence-Based Practice*
  • Humans
  • Linguistics
  • Personality Inventory / statistics & numerical data*
  • Psychometrics / statistics & numerical data
  • Reproducibility of Results
  • Surveys and Questionnaires