The Hamilton Anxiety Scale
The Hamilton Anxiety Scale is one of the most commonly used psychological questionnaires to assess a person’s degree of anxiety. It is therefore not a diagnostic tool, but a useful and highly effective resource to assess the patient’s condition, psychosomatic symptoms, fears and cognitive processes.
One fact about this interesting scale catches our attention: it was designed in 1959 by Max R. Hamilton and remains one of the most used.
This professor of psychiatry and later president of the British Psychological Society believed that not all anxiety states are the same. He didn’t just want to define another instrument for diagnosing a disorder.
It sought to define a highly rigorous resource to assess the degree of severity of anxiety in a person, also differentiating psychic from somatic anxiety due to its importance in defining people’s ability to control this very stressful reality.
Later, in 1969, Dr. Hamilton wanted to go one step further and improve the scale. Thus, among the items focused on the assessment of somatic anxiety, he made a distinction between muscle somatic signals and sensory somatic signals.
Thus, and with this degree of refinement in designing a test that is as tight as possible, we already intuit an obvious clue on this subject: each person experiences anxiety in a particular way.
No two realities are alike, so the same therapeutic strategies do not fit all. Tests like the one we’ll detail are very suitable for customizing treatments as much as possible based on the specific needs of each patient.
The purpose of the Hamilton Anxiety Scale
The Hamilton Anxiety Scale is a clinical assessment instrument used to measure a person’s degree of anxiety. It is useful for both children and adults.
It’s also a tool that can be used by doctors and psychiatrists, but of course it doesn’t make a diagnosis of a specific disorder (although it can help you).
Furthermore, there is a problem with this clinical feature that health professionals have already noticed. The Hamilton Anxiety Scale is free to access, anyone can download the tool or even take the test online.
Thus, it is common for many people to go to their doctors with the diagnosis ready: ‘I suffer from severe anxiety’.
We can say that this is not the most appropriate. This type of test, like any other type of clinical evaluation, must be carried out by specialized professionals. In addition, the Hamilton anxiety scale has another item where the researcher must assess the state in which the patient performed the test.
It is essential, therefore, to be rigorous in this aspect, because as shown by some studies, such as the one carried out by psychiatrists Katherine Shear and Vander Bilt, in the Hamilton anxiety scale the interview itself during the administration of the test is essential for a good diagnosis.
Items the Hamilton Anxiety Scale Ratings
This instrument consists of 14 items. Each question has five response options, ranging from ‘absent’ to ‘very serious’.
A score of 17 or less indicates mild anxiety. A score between 18 and 24 points would already give us an idea of a state of moderate anxiety. Finally, if we get a score between 24 and 30, this will indicate a severe state of anxiety.
Let’s see below the 14 items that make up the test:
- Anxious mind: constant worry, anguish when thinking or imagining certain things, always anticipating the worst…
- Tension: trembling, desire to cry, feeling of alarm…
- Fear: fear of being alone, of the darkness, of something unexpected happening…
- Insomnia.
- Cognitive problems: difficulty in decision, concentration, reflection, memory failure…
- Mood: discouragement, negative thoughts and the feeling that it’s going to be a bad day, irritation, bad mood.
- Muscle somatization: bruxism, tremors, muscle stiffness, muscle pain, trembling voice…
- Sensory somatization: tinnitus, blurred vision, feeling cold or hot, feeling weak…
- Cardiovascular symptoms: tachycardia or sudden stabbing pains in the chest.
- Respiratory symptoms: feeling short of breath, pressure, suffocation…
- Gastrointestinal symptoms: swallowing problems, digestion, constipation or diarrhea…
- Genitourinary symptoms: constant urination, lack of libido…
- Autonomic symptoms: dry mouth, pallor, sweating, chills…
- Professional assessment: here the specialist makes a general assessment of their perception of the patient’s condition.
Conclusion
To conclude, it is only necessary to emphasize one essential aspect. The Hamilton Anxiety Scale is an open-access resource, but psychiatrists or psychologists are the ones who are truly qualified to make the assessment and diagnosis.
Later, based on the result, one strategy or another will be chosen. Dr. Hamilton’s purpose in the 1960s was to get a reliable profile of each person’s anxiety level. Only from it will we be able to act in the best way, in the most appropriate way.
In these cases, aspects such as the patient’s tone of voice, posture, and clarity to understand or not the issues are essential to make a correct assessment.
