Specificity of trait anxiety in anxiety and depression: Meta-analysis of the State-Trait Anxiety Inventory

Abstract

The State-Trait Anxiety Inventory - Trait version (STAI-T) was developed to measure an individual's tendency to experience anxiety, but it may lack discriminant evidence of validity based on strong observed relationships with measures of depression. The present series of meta-analyses compares STAI-T scores among individuals with depressive disorders, anxiety disorders, and nonclinical comparison groups, as well as correlations with measures of anxiety and depressive symptom severity, in order to further examine discriminant and convergent validity. A total of 388 published studies (N = 31,021) were included in the analyses. Individuals with an anxiety disorder and those with a depressive disorder displayed significantly elevated scores on the STAI-T compared to nonclinical comparison groups. Furthermore, anxiety and depressive symptom severity were similarly strongly correlated with the STAI-T (mean r = .59 - .61). However, individuals with a depressive disorder had significantly higher STAI-T scores than individuals with an anxiety disorder (Hedges's g = 0.27). Given these findings, along with previous factor analyses that have observed a depression factor on the STAI-T, describing the scale as a measure of 'trait anxiety' may be a misnomer. It is proposed that the STAI-T be considered a non-specific measure of negative affectivity rather than trait anxiety per se.

Keywords: Depression; Meta-analysis; Negative affectivity/neuroticism; STAI; Trait anxiety.

Figure 1.

Conceptual model demonstrating how trait anxiety can lead to the development of OCD through cognitive and behavioral sequelae.

Figure 2.

Total citations of trait anxiety measures Source: Web of Science database search conducted March 30, 2020. Note: Costa & McRae (1992) references include only citations of the NEO-PI-R that mention anxiety; there are currently 11,109 total references citing the NEO-PI-R.

Figure 3.

PRISMA screening diagram.

Figure 4.

Comparison of STAI-T scores for anxiety and depressive disorders vs. nonclinical comparison groups. Note. CI = confidence interval; GAD = generalized anxiety disorder; OCD = obsessive-compulsive disorder; PD = panic disorder; PTSD = posttraumatic stress disorder; SAD = social anxiety disorder (generalized); SP = specific phobia; MDD = major depressive disorder

Figure 5.

Comparison of STAI-T scores for comorbid anxiety + depressive disorders vs. single disorder. Note. CI = confidence interval

Figure 6.

Correlations between the STAI-T and measures of anxiety and depressive symptom severity. Note. CI = confidence interval