Comparison of assessment tools
Beck Anxiety Inventory (BAI)
The BAI is a 21-item self-report assessment that is designed to measure levels of anxiety. Osman, Kopper, Barrios, Osman, & Wade (1997) acknowledges that the BAI was designed to measure the level of anxiety symptoms that a client displays (Osman, Kopper, Barrios, Osman, & Wade, 1997). The normative sample was 810 psychiatric patients. The learner thought that was a pretty small sample size and that was only developed on that specific population. Dowd (n.d) also cautioned readers about interpreting the results based off of that population (Dowd, n.d).
The BAI was praised about it’s reliability and validity properties. Dowd (n.d) stated that internal consistency for this instrument ranged between .85 and .94 (Dowd, n.d). This is excellent and is reassuring for this aspect of reliability. Internal consistency shows whether the items on the instrument are related to each other, and is also based on the number of items that is on the test. The BAI would not have good internal consistency if some of the questions were related to anxiety and some were related to substance abuse. Sanford, Bush, Stone, Lichstein, & Aguillard (2008) says that the BAI contains different somatic items that could be symptomatic of anxiety (Sanford, Bush, Stone, Lichstein, & Aguillard, 2008).
The BAI was also shown to have good test-retest reliability. Test-retest reliability is when the assessment is given twice within a short time period (usually less than 2 weeks). The point of this is to see if the results consistent if the client takes the test more than once. The learner is still concerned about clients being able to fake their answers on the BAI, but that could be said for other instruments as well.
Dowd (n.d) gave the BAI a glowing endorsement when discussing the validity of the BAI. The BAI is able to distinguish between anxiety and depression accurately. However, the learner was intrigued because the authors of a research study concluded the opposite. Muntingh, Feltz-Cornelis, Marwijk, Spinhoven, Penninx, & Balkom (2011) says that it is not suitable to discriminate between anxiety and depression symptoms (Muntingh et al., 2011). Muntingh (2011) also acknowledges that it is difficult to accurately assess anxiety levels (Muntingh et al., 2011). The BAI does not differentiate between different aspects of anxiety.
A positive aspect of the BAI is that it comes with an excellent instruction manual. Dowd (n.d). acknowledges that it is very detailed and specific about how it should be administered. On the other hand, while the manual is very useful for the clinician, it might be the opposite for test users. Some clients might want more information about the BAI, but it would be our responsibility to answer clients’ questions and concerns the norms that the BAI was based off of appears rather small in the learner’s opinion. There was a lot of thought put into the manual so that clinicians would have a clear understanding of how it should be administered properly. This is a very positive idea worth noting because not all assessment tests come with a proper or detailed instruction manual. Another positive aspect that has been duly noted is that the BAI is quick and simple to administer. This is a huge component because sometimes we will have clients who may not have the patients or be willing to engage in the assessment process. We can use the short administration time as strength by telling the client that this is a brief assessment that is helpful for us to be able to gain a better understanding of them. By reframing the purpose of the assessment and trying to engage the client by building trust that can help us when we want to assess for possible anxiety symptoms. However, it must be taken into account that the BAI is a self-report measurement and that also means that clients can fake good or fake bad if they want to distort results to one extreme or the other.
State-Trait Anxiety Inventory (STAI)
The STAI is an assessment tool that is designed to measure different levels and types of anxiety. This instrument measures state anxiety and trait anxiety, and recognizes that anxiety can be present as a flexible construct (Dreger, n.d). This assessment has 40 test items that is designed to measure whether the person is experiencing anxiety temporarily or if it is a stable personality trait. Elwood, Wolitzky-Taylor, Olatunji (2012) defined trait anxiety as, “A characteristic predisposition to appraise stimuli as threatening and respond with anxiety”(Elwood, Taylor, & Olatunji, 2012, p. 648). In comparison, state anxiety is usually temporary and goes away once the stressful situation is alleviated. The STAI is also a self-report instrument that can be used quickly to help assess the client’s level of symptomology regarding anxiety. This is a commonly used assessment that is used to measure the amount and level of anxiety that a client may be presenting and it has received glowing reviews. This assessment tool has been revised since its initial construction in 1964. Groth-Marnat (2003) says that there are different forms of this instrument, and that there is a specific form that is used for children called the State-Trait Anxiety Inventory for Children (G., 2003).
The sample size for the STAI was taken on a broader population than the BAI, and that impressed the learner. The normative sample for the STAI is 2,677 individuals from different populations. It incorporated high school students, college students, prisoners, and other populations (Dreger, n.d). Whereas the BAI only did it on psychiatric patients, the STAI attempted to incorporate different populations in their initial study so they could get a better idea of how valid and reliable the test would be. Reliability was excellent on the STAI, as it “Ranged from .83 to .92 for state anxiety and .86 to .92 for trait anxiety (G., 2003). Mornat (2003) said that test-retest reliability did not range well for state anxiety rating it from .36 to .51 (G., 2003). However, their measurements for state anxiety was a lot better ranging from .73 to .86 (G., 2003). The learner learned that the closer to 1 the number is in regards to reliability and validity then that means that is more likely to be reliable and valid. When she first started this course, looking at all of the numbers on these assessments felt like she was reading a foreign language for the first time. Having good test-retest reliability is important because it would show if the STAI is consistent in what it measures or not. There would be no point in using the STAI to measure anxiety in clients if it has low test-retest reliability because that means that the results would not be consistent whenever it is administered. If a client takes it twice within a two-week period of time, the scores should be in a similar range considering the short time period that the client took it twice.
Validity was found to be good in Katkin’s review of the STAI. Having good validity is important because the STAI would be meaningless if it did not measure what it is supposed to measure. The entire concept of validity is based on it measuring what it was designed to measure. If it turned out that the STAI measured levels of alcohol abuse instead of anxiety symptoms then the test, as a whole would test low for all aspects of validity. Clients would also be less likely to take the clinician seriously if they try to administer an assessment that has nothing to do with their presenting problem or the issues that the client mentions in the session. This emphasizes the importance of ensuring that the STAI is reliable and valid for the population that it is going to be used for. Balsamo, Romanelli, Innamorati, Ciccaresi, Carlucci, & Saggino (2013) states that establishing construct validity can be problematic with self-report instruments because of how the test items are grouped (Balsamo et al., 2013). The concept of construct validity refers to whether this test measures the construct that it was designed to measure. Counselors would lose credibility especially among psychologists if they were administering assessments with low construct validity. The topic of counselors being allowed to administer assessment testing has been a hotly debated topic for years in the counseling/psychology field. We need to be cognizant of making sure that we check for validity in each assessment, and make sure that the instrument is appropriate to be used with that client and that we are able to give the assessment. The ACA Code of Ethics (2014) mandates that we are obligated to only use assessments that we are trained to use and section E.2.b discusses the appropriate use aspect in that we are held responsible (, 2014). In this instance, the STAI would have high construct validity if it were determined to measure anxiety. The STAI has been used in China as that population has had concerns about anxiety. Cao & Liu (2015) state that the STAI has been used with college students and adults in China, and not with children (Cao & Lui, 2015). This is excellent to show that it has been used in diverse populations, and that it can be clinically effective for other populations.
Comparing the BAI and the STAI
The BAI and the STAI are both assessment tools that are self- report instruments. The ACA Code of Ethics (2014) mandates in section E.3.a that we give clients a thorough explanation of the results to the client and that they are fully informed to the purpose of the assessment before they take it (, 2014). They are entitled to know the purpose of the assessment and give consent and ask questions about the BAI or STAI. Both of these assessments are also designed to measure anxiety levels. However, the STAI measures state and trait anxiety. Elwood (2012) says in her article that the STAI generally considers anxiety as a part of an individual’s personality (Elwood et al., 2012). The BAI and STAI are both quick to administer, and have displayed good test-retest reliability. The BAI was initially tested out on only psychiatric outpatients, and the learner saw that as a negative. On the other hand, the STAI used different groups of participants for their normative sample. It would be difficult to put too much stock into the normative sample for the BAI because the results would not be a good representation for all populations. The learner would have loved to have seen what the results of the BAI would have been if they had other populations represented within their sample.
Dowd (n.d) declared that the BAI displayed good discriminant validity. It easily differentiated between anxiety and depression. Stulz and Christoph (2010) said that the BAI was designed to separate depression from anxiety (Stulz & Christoph, 2010). The STAI is also very good in regards to discriminant validity. Marnat (2003) said that scores on trait anxiety could fluctuate, but that would be acceptable (G., 2003). The review in the mental measurements yearbook also said a similar sentiment about the STAI. This makes sense to the learner because traits are unique and different in each individual.
Conclusion
In this assignment, the learner had the opportunity to compare the BAI and the STAI. She managed to learn about anxiety and the psychometric properties on both instruments. She also had an opportunity to apply some of the concepts about reliability and validity. It helped her practice the concepts that she learned so that she could understand how they are used in assessments…
References
(2014). ACA Code of Ethics. []. Retrieved from Capella
Balsamo, M., Romanelli, R., Innamorati, M., Ciccarese, G., Carlucci, L., & Saggino, A. (2013). The State-Trait Anxiety Inventory: Shadows and lights on its constructive validity. . Retrieved from Capella Library
Cao, Y., & Lui, Z. (2015). Use of the state-trait anxiety inventory with children and adolescents in China: Issues with reaction times. . Social Behavior and Personality. Retrieved from Capella Library
Dowd, T. (n.d). Review of the Beck Anxiety Inventory. Mental Measurements Yearbook. Retrieved from Capella Library
Dreger, R. (n.d). Review of the State-Trait Anxiety Inventory. Mental Measurement Yearbook. Retrieved from Capella Library
Elwood, L., Taylor, W., & Olatunji, B. (2012). Measurement of anxious traits: A contemporary review and synthesis. Anxiety, Stress, & Coping. Retrieved from Capella Library
G., G. (2003). Handbook of Psychological Assessment (4th ed.). : John Wiley & Sons.
Muntingh, A., Feliz-Corneliz, C., Marwijk, H., Spinhoven, D., Penninx, B., & Balkom, A. (2011). Is the beck anxiety inventory a good tool to assess the severity of anxiety? A primary care study in the Netherlands study of depression and anxiety (NESDA). Family Practice. Retrieved from Capella Library
Osman, A., Kopper, B., Barrios, F., Osman, J., & Wade, T. (1997). The Beck Anxiety Inventory: Reexamining of Factor Structure and psychometric properties. Journal of Clinical Psychology. Retrieved from Capella Library
Sanford, S., Bush, A., Stone, K., Lichstein, K., & Aguillard, N. (2008). Psychometric evaluation of the Beck Anxiety Inventory: A sample with sleep-disordered breathing. Behavioral Sleep Medicine. Retrieved from Capella Library
Stulz, N., & Christoph, P. (2010). Distinguishing anxiety and depression in self-report: Purification of the Beck Anxiety Inventory and Beck Depression Inventory-II. Journal of Clinical Psychology. Retrieved from Capella Librar