Arthritis & Rheumatism (Arthritis Care & Research) Vol. 49, No. 5S, October 15, 2003, pp S165–S174 DOI 10.1002/art.11408 © 2003, American College of Rheumatology
MEASURES OF PSYCHOLOGICAL STATUS AND WELL-BEING
Other Measures of Psychological Well-Being The Affect Balance Scale (ABS), General Health Questionnaire (GHQ-12), Life Satisfaction Index-A (LSI-A), Rosenberg Self-Esteem Scale, Satisfaction with Life Scale (SWLS), and State-Trait Anxiety Index (STAI)
Kathleen M. Schiaffino AFFECT BALANCE SCALE (ABS) General Description Purpose. To assess positive and negative affect as indicators of life satisfaction and/or well-being (1,2). Content. Five positive affect questions and 5 negative affect questions. Developer/contact information. Norman M. Bradburn. Studies conducted by the National Organization for Research (NORC) at the University of Chicago in the 1960s resulted in the publication The Structure of Psychological Well-Being by Bradburn (1), which contains a description of the Affect Balance Scale. Available at http://cloud9.norc.uchicago.edu. Versions. The ABS has been translated into many languages, including Cantonese, Vietnamese, and Laotian; cultural equivalence was found (3). Number of items in scale. There are 10 items.
Other uses. None. WHO ICF Components. Not applicable.
Administration Method. Self-report. Training. None. Time to administer/complete. Brief. Equipment needed. None. Cost/availability. Not copyrighted. The measure is available at http://cloud9.norc.uchicagoedu/dlib/ spwb/summary.htm. Full-text chapters of The Structure of Psychological Well-Being (1) are available as PDF files at http://cloud9.norc.uchicago. edu/dlib/spwb/index.htm. The ABS is discussed at length in Chapter 4.
Scoring Responses. Scale. Yes or no.
Subscales. Positive affect, Negative Affect, and Affect Balance, which is the difference between Positive Affect and Negative Affect and is sometimes used as an indicator of overall happiness. Populations. Developmental/target. General Population.
Kathleen M. Schiaffino, PhD: Fordham University, Bronx Fordham University, Bronx, New York. Address correspondence to Kathleen Schiaffino, PhD, Bronx Fordham University, Bronx, NY 10458. E-mail: schiaffi
[email protected]. Submitted for publication April 23, 2003; accepted April 24, 2003.
Score range. The range is 0 –5 for positive and for negative affect. Interpretation of scores. Higher scores indicate higher positive and higher negative affect. Method of scoring. Positive and negative questions summed separately, with a score of 1 for a “yes” response and a score of 0 for a “no” response. Affect Balance is computed as the difference between Positive Affect and Negative Affect. Time to score. Brief. Training to score. None. S165
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Training to interpret. None. Norms available. Typical responses for specific populations can be drawn from existing literature (3–10).
Psychometric Information Reliability. Generally strong reliability. Bradburn (1) reported test-retest reliability on a sample of 200 over a 3-day period for Positive Affect, Negative Affect, and Affect Balance to be 0.83, 0.81. and 0.76, respectively. Internal consistency reliabilities for Positive Affect range between 0.55 and 0.73; for Negative Affect scores range between 0.61 and 0.73. Bassett et al (4) evaluated the agreement between self-report and rater versions of 4 mental health measures, including ABS, in a sample of 538 individuals. Results indicated a strong association. This association was found even for respondents classified as depressed or cognitively impaired. Although there was evidence of rater bias, with raters underrating affective status and overrating cognitive status, the magnitude of the bias proved small. Validity. Bradburn (1) showed that positive affect correlated with single-item indicators of happiness from 0.34 to 0.38 and with corresponding values for negative affect at ⫺0.33 and ⫺0.38. He hypothesized that positive and negative affect were distinct dimensions; this was supported by small associations between the scales (0.04 – 0.15). Factor analyses have also indicated distinct orthogonal dimensions Others have also found positive and negative affect to be orthogonal dimensions, with negligible or weak negative associations, supporting the twofactor theory which “maintains that positive and negative affect represent statistically independent dimensions of subjective well-being, with positive affect more related to situational factors and negative affect more related to dispositional factors” (5). Sensitivity/responsiveness to change. For people at all ages, negative affect appears to decrease over time. “Looking at all three age groups together, negative affect decreased steadily until around age 60, at which time the rate slowed significantly. Unlike the hypothesized upturn in very old age, the decline continued even in very old age” (6). Maitland et al (7) have found stability in positive and negative affect factors over 3 years in a Victoria sample aged 54 – 87. Factor loadings remained largely invariant over time. Some differences in sex loadings emerged.
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Comments and Critique A model of subjective well-being has been proposed and tested by Liang which integrates the ABS and the Life Satisfaction Index–Version A (LSIA). The proposed model employs 8 ABS items and 7 LSIA items and is presumed to measure 4 dimensions: congruence, happiness, positive affect, and negative affect. Liang (8) successfully replicated this model across 4 randomly divided subsamples; Lawrence and Liang (9) reported further evidence for the stability of the model structure across age and sex, but noted some variability when comparing African American and White samples and conclude that the meaning of subjective well-being may differ for these two groups. Evidence seems to suggest that positive and negative affect are independent of each other and that they have different etiologies with positive affect being influenced by environmental factors, and negative affect deriving more from stable, perhaps genetic, factors. “There is a heritable basis of negative affect, perhaps stemming from genetically influenced personality characteristics. Situational variables that family members share are of greater importance for explaining family resemblance for positive affect” (5). This emphasis on the independence of the 2 factors makes the use of a difference score to obtain an indication of “Affect Balance” conceptually problematic. Moreover, fundamental weaknesses in the ABS have been argued, including the fact that affect items more strongly reflect arousal content; items include non-affect content; intensity/frequency of affect is not assessed; response bias may lead to ceiling or floor effects (10).
References 1. (Original) Bradburn NM. The structure of psychological well-being. Chicago: Aldine; 1969. 2. Bradburn NM, Caplovitz D. Reports on happiness. Chicago: Aldine; 1965. 3. Devins GM, Beiser M, Dion R. Cross-cultural measurements of psychological well-being: the psychometric equivalence of Cantonese, Vietnamese, and Laotian translations of the Affect Balance Scale. Am J Public Health 1997;87:794 –9. 4. Bassett SS, Magaziner J, Hebel JR. Reliability of proxy response on mental health indices for aged, community-dwelling women. Psychol Aging 1990;5: 127–32. 5. Baker LA, Cesa IL, Gatz M, Mellins C. Genetic and environmental influences on positive and negative affect: support for a two-factor theory. Psychol Aging 1992;7:158 – 63. 6. Charles ST, Reynolds CA, Gatz M. Age-related differences and change in positive and negative
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affect over 23 years. J Pers Soc Psychol 2001;80:136 – 51. Maitland SB, Dixon RA, Hultsch DF, Hertzog D. Well-being as a moving target: measurement equivalence of the Bradburn Affect Balance Scale. J Gerontol 2001;56:P69 –77. Liang J. A structural integration of the Affect Balance Scale and the Life Satisfaction Index A. J Gerontol 1985;40:552– 61. Lawrence RH, Liang J. Structural integration of the Affect Balance Scale and the Life Satisfaction Index A: race, sex, and age differences. Psychol Aging 1988;3:375– 84. Diener E. Subjective well-being. Psychol Bull 1984; 95:542–75.
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coping (4) in the GHQ-12. Factor structures vary in the larger versions. Populations. Developmental/target. Community and non-psychiatric clinical samples. Other uses. None. WHO ICF Components. Not applicable.
Administration Method. Self-report. Training. None.
Additional Reference McDowell I, Newell C. Measuring health: a guide to rating scales and questionnaires, Second Edition. Oxford (UK): Oxford University Press; 1996. pp. 191–194.
GENERAL HEALTH QUESTIONNAIRE (GHQ-12) General Description Purpose. To screen for minor psychiatric (nonpsychotic) disorders in community and nonpsychiatric clinical settings (1). Content. The items of the GHQ-12 were selected from the pool of 60 items comprising the original questionnaire, GHQ-60. Items focus on the inability to carry out normal activities and the appearance of new and distressing symptoms, i.e., depression, anxiety, observable behaviors, and hypochondriasis.
Time to administer/complete. Brief. Equipment needed. None. Cost/availability. Packets of 100 can be obtained via the website indicated above at approximately £30.50 (English pounds) plus tax.
Scoring Responses. Scale GHQ-12. Items ask whether a particular symptom or behavior has been recently experienced. Responses are indicated using one of two 4-point scales depending on the nature of the question: either “Better than usual; Same as usual; Worse than usual; Much worse than usual” OR “Not at all; No more than usual; Rather more than usual; or Much more than usual.” Score range. The range is 0 – 4 for each item. There are 2 different scoring options, described below.
Developer/contact information. D. P. Goldberg, University of Manchester, UK. Copies of the GHQ12 can be obtained from National Foundation for Educational Research–Nelson Publishing Company Ltd., Darville House, Oxford Road East, Windsor, Berkshire SL4 1DF, UK or http://www.nfer-nelson.co.uk/default.asp.
Interpretation of scores. Using receiveroperating characteristic analysis, threshold cutting scores of “1 or 2” and “3 or 4” have been identified in various studies. A cut-off of 1 or 2, indicating a positive response to 1 or 2 items, is most commonly used. The higher cut-off has been recommended for elderly respondents (5).
Versions. GHQ-12, GHQ-20, GHQ-28, GHQ-30, and GHQ-60.
Method of scoring. Can be scored in 2 ways: the binary or Likert method. The binary method identifies individuals reporting sufficient psychological distress to be probable cases of minor psychiatric disorder. The first 2-response categories are scored as 0 and the latter 2 as 1. The possible scale score is 0 –12. The Likert method assigns a value of 0, 1, 2, and 3 to each response category, and takes the mean of all 12 scores.
Number of items in scale. There are 12, 20, 28, 30, and 60 items, respectively. Items for the various versions can be found in McDowell and Newell (2). Subscales. Studies have suggested the presence of 2 factors: depression and social dysfunction (3) and 3 factors: self-esteem, stress, and successful
Time to score. Brief.
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Training to score. Brief. Training to interpre. Minimal. Norms available. Typical responses for specific populations can be drawn from existing literature (2–10).
Psychometric Information Reliability. The GHQ-12 has alpha coefficients for the 12 items at mid to high 0.80s. Test-retest correlations at 2 weeks have been reported at 0.73 (6) and at 6 months between 0.75 and 0.90 (2). Validity. Correlates highly with the Symptom Check-List (SCL-90; [7]) and other mental health measures (such as the Brief Screen for Depression) and least with a Muscle Fatigue scale, providing evidence of discriminant validity (6). Reliable and valid for identifying mental disorders when used by primary care physicians in Germany (7) and when used with elderly subjects, with comparable performance across age groups and in the presence of mild intellectual impairment (5). Validity not affected by variations in factor structure (3), which may be at least partially attributable to the reporting of GHQ-12 scores which have been extracted from one of the larger versions (embedded) rather than administered as a distinct scale (8). Variations in factor structure may also be attributable to cultural differences (9). Sensitivity/responsiveness to change. The GHQ12 has been consistent and reliable with samples with relatively long (i.e., yearly) intervals between applications (10).
Comments and Critique One limitation is the possible insensitivity of the GHQ-12 in identifying depressive disorder (6). In addition, the factor structure appears to be unstable both within and across cultures. Finally, most evidence for discriminant validity for psychological disorders is based upon evidence from clinical interviews and not from standardized measures.
References 1. (Original) Goldberg DP. The detection of psychiatric illness by questionnaire (Maudsley Monograph No. 21).Oxford (UK): Oxford University Press; 1972. 2. McDowell I, Newell C. Measuring health: a guide to rating scales and questionnaires, Second Edition. Oxford (UK): Oxford University Press; 1996, p. 225– 37.
Schiaffino 3. Werneke U, Goldberg DP, Yalcin I, Ustun BT. The stability of the factor structure of the General Health Questionnaire. Psychol Med 2000;30:823–9. 4. Martin AJ. Assessing the multidimensionality of the 12-item General Health Questionnaire. Psychol Rep 1999;84:927–35. 5. Papassotiropoulos A, Heun R, Maier W. Age and cognitive impairment influence the performance of the General Health Questionnaire. Compr Psychiatry 1997;38:335– 40. 6. Hardy GE, Shapiro DA, Haynes CE, Rick, JE. Validation of the General Health Questionnaire-12 using a sample of employees from England’s Health Care Services. Psychol Assess 1999;11:159 – 65. 7. Schmitz N, Kruse J, Heckrath C, Alberti L, Tress W. Diagnosing mental disorders in primary care: The General Health Questionnaire (GHQ) and the Symptom Checklist (SCL-90-R) as screening instruments. Soc Psychiatry Psychiatr Epidemiol 1999;34:360 – 6. 8. Van Hemert AM, den Heijer M, Vorstenbosch M, Bolk JH. Detecting psychiatric disorders in medical practice using the General Health Questionnaire: why do cut-off scores vary? Psychol Med 1995;25: 165–70. 9. Aderibigbe YA, Riley W, Lewin T, Gureje O. Factor structure of the 28-item General Health Questionnaire in a sample of antenatal women. Int J Psychiatry Med 1996;26:263–9. 10. Pevalin DJ. Multiple applications of the GHQ-12 in a general population sample: An investigation of longterm retest effects. Soc Psychiatry Psychiatr Epidemiol 2000;35:508 –12.
LIFE SATISFACTION INDEX A (LSI-A) General Description Purpose. To assess life satisfaction in older adults. Content. Items assess 5 components: zest (versus apathy), resolution and fortitude, congruence between desired and achieved goals, positive selfconcept, and mood tone. Developer/contact information. Neugarten BI, Havighurst RJ, Tobin SS. The measurement of life satisfaction. (1). Available at www.medal.org. Versions. Life Satisfaction Index–A and Life Satisfaction Index–B. The most commonly used measure is Life Satisfaction Index–A (LSI-A) that will be described here. Various translations exist. Number of items in scale. There are 20 items. Subscales. None. Populations. Developmental/target. Older adults.
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Other uses. None. WHO ICF Components. Not applicable.
Administration Method. Self-report. Training. None. Time to administer/complete. Brief. Equipment needed. None. Cost/availability. No cost; not copyrighted.
Scoring Responses. Scale. There are 3 responses: “agree,” “disagree,” or “I don’t know.” Score range. Range is 0 – 40. Interpretation of scores. Higher scores indicate greater life satisfaction. Method of scoring. For positively-worded items, “Agree” responses are scored 2 points; for negatively-worded items “Disagree” responses are scored 2 points. “I don’t know” responses are scored 1 point. Total scored by summing all points for the 20 statements. Time to score. Brief. Training to score. Minimal. Training to interpret. Minimal. Norms available. Typical responses for specific populations can be drawn from existing literature (2–7). McDowell and Newell (2) report evidence for consistent means scores across samples.
Psychometric Information Reliability. Wallace and Wheeler (3) reviewed 157 journal articles for reliability information resulting in a review of 34 samples. In this review, an average reliability of 0.79 was found. Correlations suggested that LSI-A reliability was unrelated to sample characteristics such as sample size, age and sex. “No significant differences in score reliability were found by language of administration or sample type. These analyses provide evidence for adequate reliability of LSI scores across a variety of sample characteristics. . .” (3).
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Validity. LSI-A correlated 0.39 with clinical ratings using the LSR (Life Satisfaction Ratings), which uses an interview to evaluate the 5 hypothesized components of life satisfaction (1). The following attitudes have been found to be associated with life satisfaction: 1) zest for life as opposed to apathy; 2) resolution and fortitude as opposed to resignation; 3) congruence between desired and achieved goals; 4) high physical psychological and social self-concept; 5) happy optimistic mood tone. Sensitivity/responsiveness to change. No reported information.
Comments and Critique McDowell and Newell (2) confirmed the stability of the factor structure, but McCulloch (4) found the factor structure to be affected by sex and race. There is a need for conceptual clarity of what is meant by life satisfaction, morale, and other terms related to subjective well-being (5). A model of subjective well-being has been proposed and tested by Liang that integrates the Affect Balance Scale (ABS) and the LSIA. The proposed model employs 8 ABS items and 7 LSIA items and is presumed to measure 4 dimensions: congruence, happiness, positive affect, and negative affect. Liang (6) successfully replicated this model across four randomly divided subsamples; Lawrence and Liang (7) reported further evidence for the stability of the model structure across age and sex, but note some variability when comparing African American and White samples and conclude that the meaning of subjective well-being may differ for these 2 groups.
References 1. (Original) Neugarten BI, Havighurst RJ, Tobin SS. The measurement of life satisfaction. J Gerontol 1961;16: 134 – 43. 2. McDowell I, Newell C. Measuring health: a guide to rating scales and questionnaires, Second Edition. Oxford (UK): Oxford University Press; 1996. p. 198 – 203. 3. Wallace KA, Wheeler AJ. Reliability generalization of the life satisfaction index. Educ psychol meas. 2002; 62:674 – 84 4. McCulloch BJ. Gender and race: an interaction affecting the replicability of well-being across groups. Women Health 1992;19:65– 89. 5. Thomas LE, Chambers KO. Phenomenology of life satisfaction among elderly men quantitative and qualitative views. Psychol Aging 1989;4:284 –289 6. Liang, J. A structural integration of the Affect Balance Scale and the Life Satisfaction Index A. J Gerontol 1985;40:552– 61.
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Administration Method. Self-report. Training. None.
Additional References
Time to administer/complete. Brief.
Adams DL. Analysis of a life satisfaction index. J Gerontol 1969;24:470 – 4. Fountoulakis K, Iakovides B, Iakovides A, Christofides A, Ierodiakonou C. The validation of the life satisfaction index (LSI) in the Greek population. Psychiatriki. 1997;8:292–304 Maddox G L, Wiley J. Scope, concepts, and methods in the study of aging. In: Binstock R, Shanas E, editors. Handbook of aging and the social sciences. New York: Van Nostrand Reinhold; 1976. p. 3–34. Sauer W J, Warland R. Morale and life satisfaction. In: Mangen DA, Peterson WA, editors. Research instruments in social gerontology: clinical and social psychology. Minneapolis: University of Minnesota Press; 1982. p. 195–240. Wood V, Wylie ML, Sheafor B. An analysis of a short self-report measure of life satisfaction: correlation with rater judgments. J Gerontol 1969;24:465–9.
Equipment needed. None.
ROSENBERG SELF-ESTEEM SCALE General Description
Cost/availability. No cost. See contact information.
Scoring Responses. Scale. The scale ranges from “Strongly agree” to “strongly disagree.” Score range. Items score from 0 to 3; scale range ⫽ 0 to 30. Interpretation of scores. Higher scores indicate higher self-esteem. Method of scoring. For items 1, 2, 4, 6, 7 “strongly agree” ⫽ 3 and “strongly disagree” ⫽ 0. For items 3, 5, 8, 9, 10 a “strongly agree” ⫽ 0 and “strongly disagree” ⫽ 3.
Purpose. To assess self-esteem, defined as selfacceptance or a positive or negative orientation toward self (1).
Time to score. Brief.
Content. Ten items reflecting thoughts and feelings about oneself as an object.
Training to interpret. Brief.
Developer/contact information. Morris Rosenberg. Not copyrighted. Information available at www.bsos.umd.edu/socy/grad/rosenberg.doc. Versions. None The scale has been translated into a variety of languages. Number of items in scale. There are 10 items. Subscales. None. Some studies have identified a 2-factor structure (self-confidence and selfdeprecation) although it is widely argued that these factors are an artifactual separation of positive and negative items (2). Populations developmental/target. Originally developed for adolescent samples. Other uses. Has been used with the full range of adolescent and adult populations. WHO ICF Components. Not applicable.
Training to score. Brief.
Norms available. It is the most widely used global self-esteem measure available. Normative information best obtained by reviewing previous research uses with comparable populations.
Psychometric Information Reliability. Test-retest correlations range from 0.82 to 0.88; internal consistency reliabilities tend to range from 0.77 to 0.88 (3). Rosenberg reported a test-retest coefficient of 0.92 and an alpha coefficient of 0.72 (1). Validity. Significant correlations between selfesteem and clinical ratings of depression. The Rosenberg Self-Esteem Scale is the standard against which other measures of self-esteem, self-efficacy, mastery, self-concept, etc. are tested (4 –7). Coleman et al (8) note that Rosenberg has presented good evidence for the convergent and predictive validity of the scale.The evidence for discriminant validity is less strong.
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Sensitivity/responsiveness to change. Rosenberg conceived of self-esteem as a stable characteristic of adults (1).
Content. Five items: life close to ideal; conditions of life excellent; satisfied with life; gotten things I want; would change almost nothing.
References
Developer/contact information. Diener et al (1). Available at www.psych.uiuc.edu/⬃ediener.
1. (Original) Rosenberg M. Society and the adolescent self-image. Princeton (NJ): Princeton University Press; 1965. (Chapter 2 discusses construct validity.) 2. Marsh HW. Positive and negative global self-esteem: a substantively meaningful distinction or artifactors? J Pers Soc Psychol 1996;70:810 –9. 3. Blascovich J, Tomaka J. Measures of self-esteem. In: Robinson JP, Shaver PR, Wrightsman LS, editors. Measures of personality and social psychological attitudes. Third Edition. Ann Arbor (MI): Institute for Social Research; 1993. p. 115– 60. 4. Lorr M, Wunderlich RA. Two objective measures of self-esteem. J Pers Assess 1986;50:18 –23. 5. Diener E, Emmons RA, Larson RJ, Griffin S. The satisfaction with life scale. J Pers Assess 1985;49:71– 5. 6. Linton KE, Marriott RG. Self-esteem in adolescents: validation of the State Self-esteem scale. Person Individual Diff 1996;21:85–90. 7. Robins RW, Hendin HM, Trzesniewski KH. Measuring global self-esteem: construct validation of a singleitem measure and the Rosenberg Self-Esteem Scale. Personality Soc Psychol Bull 2001;27:151– 61. 8. Coleman PG, Aubin A, Robinson M, Ivani-Chalian C, Briggs R. Predictors of depressive symptoms and low self-esteem in a follow-up study of elderly people over 10 years. Int J Geriatric Psychol 1993;8:343–9.
Additional References Owens TJ. Two dimensions of self-esteem: reciprocal effects of positive self-worth and self-deprecation on adolescent problems. Am Sociol Rev 1994;59: 391– 407. Owens TJ. Accentuate the positive and the negative: rethinking the use of self-esteem, self-deprecation, and self-confidence. Social Psychol Q 1993;56:288 – 99. Silber E, Tippett J. Self-esteem: Clinical assessment and measurement validation. Psychol Rep 1965;16: 1017–71. Wells LE, Marwell G. Self-esteem: its conceptualization and measurement. Beverly Hills (CA): Sage; 1976. Wylie RC. The self-concept. Lincoln, (NE): University of Nebraska Press; 1974. p. 180 –9.
SATISFACTION WITH LIFE SCALE (SWLS) General Description Purpose. To assess global judgment of life satisfaction, rather than satisfaction with specific domains.
Versions. The SWLS is available in many languages, including French, Dutch, Russian, Korean, Hebrew, and Mandarin Chinese. Number of items in scale. There are 5 items. Subscales. None. Populations. Developmental/target. General population. Other uses. None. WHO ICF Components. Not applicable.
Administration Method. Self-report. Training. None. Time to administer/complete. Brief. Equipment needed. None. Cost/availability. No cost, not copyrighted. Available at http://s.psych.uiuc.edu/⬃ediener/ hottopic/hottopic.html.
Scoring Responses. Scale. There is a 7-point scale from “strongly disagree” to “strongly agree.” Score range. Range is 5–35. Interpretation of scores. Scores can be interpreted in terms of absolute as well as relative life satisfaction. A score of 20 represents the neutral point on the scale. Scores between 31 and 35 indicate extremely satisfied, 26 –30 indicates satisfied, 21–25 indicates slightly satisfied, 15–19 indicates slightly dissatisfied, 10 –14 dissatisfied, and 5–9 extremely dissatisfied. Method of scoring. Sum indicated values for each item. Time to score. Brief. Training to score. Minimal.
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Training to interpret. None. Norms available. Typical responses for specific populations can be drawn from existing literature (see additional references).
Psychometric Information Reliability. Strong internal reliability and moderate temporal stability. Diener et al (1) report coefficient alphas of 0.79 to 0.89 and a 2-month test—retest stability coefficient of 0.64 to 0.82. Validity. Validity indicated by groups scoring lowest on the SWLS: psychiatric patients, prisoners, students in poor and turbulent countries, and abused women. The SWLS has negatively correlated with clinical measures of distress and with neuroticism and positively correlated with extraversion. Diener and Diener (2) found SWLS to be significantly correlated with satisfaction with the self in most nations. However, covariation between self-esteem and life satisfaction was lower in collectivistic nations. Sensitivity/responsiveness to change. Test—retest stability decreases to 0.50 – 0.54 over time, suggesting changes in life satisfaction may occur over time (1).
Comments and Critique Research has suggested two broad aspects of subjective well-being: an affective component, which is usually further divided into pleasant affect and unpleasant affect, and a cognitive component which is referred to as life satisfaction.
References 1. (Original) Diener E, Emmons RA, Larsen RJ Griffin S. The satisfaction with life scale. J Person Assess 1985; 49:71–5. 2. Diener E, Diener C. Most people are happy. Psychol Sci 1996;7:181—5.
Additional References Diener E, Diener M. Cross-cultural correlates of life satisfaction and self-esteem. J Pers Soc Psychol 1995;68:653– 63. Diener E, Emmons RA. The independence of positive and negative affect. J Pers Soc Psychol 1984;47: 1105–-17. Diener E, Larsen RJ. The subjective experience of emotional well-being. In: Lewis M, Haviland JM, editors. Handbook of emotions. New York: Guilford Press; 1993. p. 405–15. Diener E. Subjective well-being. Psychol Bull 1984;95: 542–75.
Schiaffino Diener E, Diener M, Diener C. Factors predicting the subjective well-being of nations. J Pers Soc Psychol 1995;69:851– 64. Diener E, Sandvik E, Pavot W, Gallaher D. Response artifacts in the measurement of subjective wellbeing. Soc Indicators Res 1991;24:36 –56. Pavot W, Diener E. Review of the satisfaction with life scale. Psychol Assess 1993;5:164 –72.
STATE-TRAIT ANXIETY INVENTORY (STAI) General Description Purpose. The STAI assesses separate dimensions of state and trait anxiety. “State anxiety refers to anxious affect, situationally provoked. . .” Trait anxiety is “. . . a person’s general disposition to be anxious.” (1). Content. Twenty items assess tension, apprehension, and nervousness. For state anxiety the response is in terms of feelings at the moment; for trait anxiety the response is in terms of how one generally feels. Developer/contact information. Spielberger (2,3); Psychological Assessment Resources, Inc., 16204 North Florida Avenue, Lutz, FL 33549. http://www.parinc.com). Versions. STAI is available in more than 40 languages. Form Y is the latest refinement of the English version. Number of items in scale. There are 20 items. Subscales. STAI was developed as a unidimensional measure. Populations. Developmental/target. General adult population. Other uses. None. WHO ICF Components. Not applicable.
Administration Method. Self-report measure; 10 items are positively worded, and 10 items are negatively worded. Training. None. Time to administer/complete. Brief. Equipment needed. None.
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Cost/availability. Copyrighted; contact: Psychological Assessment Resources, Inc. 16204 N. Florida Avenue, Lutz, FL 33549. Available at http://www.parinc.com.
Scoring Responses. Scale. 4 point scale. For state anxiety, responses are “not at all,” “somewhat,” “moderately so,” or “very much so.” For trait anxiety, responses are “almost never,” “sometimes,” “often,” or “almost always.” Score range. Range is 20 – 80. Interpretation of scores. Higher scores indicate greater levels of anxiety. Method of scoring. Positively worded items are reversed and then summed. Time to score. Brief. Training to score. None. Training to interpret. Brief. Norms available. Norms provided for college freshman, graduate students, college graduates, psychiatric patients and general medical patients. In addition, extensive literature exists involving the use of this measure.
Psychometric Information Reliability. Test-retest reliability tends to be high for Trait and low for State, as expected. Testretest for STAI Trait ranges from 0.73 to 0.86 over periods of 1 hour to 104 days. Alpha coefficients for both tests range from 0.83 to 0.95. Validity. STAI State and STAI Trait correlate between 0.59 and 0.75. Evidence for convergent validity has been observed in correlations with the Taylor Manifest Anxiety Scale (TMAS) and the Institute for Personality and Ability Testing’s Anxiety Scale (IPAT) of 0.73– 0.85. Sensitivity/responsiveness to change. The State Anxiety Scale is intended to measure transient levels of anxiety and, as such, is not expected to have high test-retest relationships. The Trait
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Anxiety Scale measures dispositional anxiety and has been shown to be relatively stable over time.
Comments and Critique The STAI is the most widely used measure of anxiety. It has been used cross-culturally with good success. Some researchers have suggested that the STAI and measures of depression like the Beck Depression Inventory may simply measure “general psychological distress” and that anxiety and depression may be impossible to accurately differentiate using existing self-report measures (4 – 6). Endler et al (6) developed measures of state and trait anxiety (EMAS) with which anxiety has been differentiated from depression. However, the EMAS-State has 20 items and the EMAS-Trait has 60 items.
References 1. Spielberger CD. Theory and research on anxiety. In: Spielberger CD, editor. Anxiety and behavior. San Diego (CA): Academic Press; 1966. p. 3–20. 2. Spielberger CD. Manual for the State-Trait Anxiety Inventory (Form V). Palo Alto (CA): Consulting Psychologists Press; 1983. 3. Spielberger CD. Anxiety as an emotional state. In: Spielberger CD, editor. Anxiety: current trends in theory and research. San Diego (CA): Academic Press; 1972. p. 24 – 49. 4. Gotlib IH. Depression and general psychopathology in university students. J Abnorm Psychol 1984;93:19 –30. 5. Dobson KS. The relationship between anxiety and depression. Clin Psychol Rev 1985;5:307–24. 6. Endler NS, Cox BJ, Parker JD, Bagby RM. Self-reports of depression and state-trait anxiety: evidence for differential assessment. J Pers Soc Psychol 1992;63: 832– 8.
Additional References Gotlib IH, Cane DB. Self-report assessment of depression and anxiety. In: Kendall PC, Watson D, editors. Anxiety and depression: distinctive and overlapping features. San Diego (CA): Academic Press 1989; p. 131– 69. Hishinuma ES, Miyamoto RH, Nishimura ST, Nahulu LB. Differences in state-trait anxiety inventory scores for ethnically diverse adolescents in Hawaii. Cult Divers Ethnic Minor Psychol 2000;6:73– 83. Novy DM, Nelson DV, Goodwin J, Rowzee RD. Psychometric comparability of the State-Trait Anxiety Inventory for Different Ethnic Subpopulations. Psychol Assess 1993;5:343–9.
State-Trait Anxiety Index (STAI)
Rosenberg SelfEsteem Scale Satisfaction with Life Scale (SWLS)
Life Satisfaction Index A (LSI-A)
General Health Questionnaire (GHQ12)
Affect Balance Scale (ABS)
Measure/scale
Positive and negative affect as indicators of life satisfaction Ability to do normal activities; distressing symptoms Zest, resolution, goal congruence, selfconcept, mood Selfacceptance Global judgment of life satisfaction Anxiety at the moment and usual anxiety
Content
Separate scores for State and Trait
Total score ranging from 0 to 30 Total score ranging from 5 to 35
Total score ranging from 0 to 40
Cut-off score of 1 or 2 indicating distress
Positive Affect, Negative Affect, and Affect Balance
Measure outputs
4-point scale
7-point scale
20
4-point scale
5
Agree, Disagree, Don’t Know
4 point scale
Yes or no
Response format
10
20
12
10
No. of items
Self
Self
Self
Self
Self
Self
Method of administration
15–20 minutes
5 minutes
10 minutes
15–20 minutes
10 minutes
10 minutes
Time for administration
College students, graduates, psychiatric patients; general medical patients
Adolescents and adults Adolescents and adults
Older adults
Various age groups, including elderly; primary care patients
Adults
Validated populations
Summary Table for Other Measures of Psychological Well-Being
Good
Excellent
Excellent
Adequate
Excellent
Good
Reliability
Adequate
Excellent
Good
Adequate
Good
Adequate
Validity
Good
Excellent
Good
Not reported
Good
Good
Responsiveness
Psychometric properties
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